Causes of Death in South Africa Advance release of recorded causes of death Launch Presentation 21 November 2002

Outline of presentation Introduction Introduction Data & methods Data & methods Key findings Key findings  Leading causes of death (levels and trends)  Differentials (gender, age, population group) Conclusion Conclusion

Introduction Last report on causes of death was for 1996 Last report on causes of death was for 1996 Statistics SA published release on recorded deaths Statistics SA published release on recorded deaths  Based on data from Population Register  For the period 1997 to 2000  Release observed rising number of deaths  Did not identify the causes contributing to increase Call from President for information on causes of death among South Africans Call from President for information on causes of death among South Africans

Aims of the present study Complement the earlier reports Complement the earlier reports Identify leading underlying causes of death for period Identify leading underlying causes of death for period Identify emerging cause of death trends & patterns during the period Identify emerging cause of death trends & patterns during the period

Data & methods Based on 12% stratified random sample Based on 12% stratified random sample  Death notification forms from DHA  For period  To expedite release of information on causes of death  records processed instead of over 2million Methodology consistent with international practice Methodology consistent with international practice  Study based on notification forms completed by medical practitioner certifying death  Coding consistent with WHO rules (ICD-10)  Quality of data determined by physicians

Leading underlying causes of death for both males and females, Unspecified unnatural causes (11%) Unspecified unnatural causes (11%) Ill-defined causes of death (8%) Ill-defined causes of death (8%) Tuberculosis (8%) Tuberculosis (8%) HIV (7%) HIV (7%) Influenza and pneumonia (6%) Influenza and pneumonia (6%) Account for 41% of deaths Account for 41% of deaths

Percentage of deaths due to the leading underlying causes by year of death,

Changing importance of leading underlying causes of deaths for both males and females, 1997 & 2001 Cause %Rank%Rank Unspecified unnatural causes Ill-defined causes TB HIV Influenza & pneumonia

Differential patterns of underlying causes of death Gender differentials Gender differentials Age differentials Age differentials Differentials by population group Differentials by population group

Percentage distribution of deaths due to leading underlying causes by gender,

Changing importance in the leading underlying causes of male deaths, 1997 & %Change %Rank%Rank TB HIV Influenza & pneumonia Ill-defined Unnatural Total

Changing importance of the leading underlying causes of female deaths, 1997 & %Change %Rank%Rank TB HIV Influenza & Pneumonia Ill-defined Cerebrovascular Total

Age differentials in leading underlying causes of death Population younger than 15: Population younger than 15:  Leading underlying cause of death intestinal infections (15.4% of male; 16.1% of female deaths)  Increased proportion of deaths due to HIV and Influenza and pneumonia as underlying cause  Malnutrition is important underlying cause of death:  Seventh leading cause of death  Accounted for 7% of male deaths  Accounted for 6% of female deaths

% Male deaths due to the leading underlying causes of death by age,

% Female deaths due to the leading underlying causes by age,

Mortality differentials in the older ages Population aged 50 and older Population aged 50 and older  Patterns of underlying causes of death are unique  Degenerative diseases major cause  Four common leading underlying causes of death for males and females are:  Cerebrovascular  Ischaemic heart disease  Other heart diseases  General symptoms & signs  Account for 41% of female and 31% of male deaths  Diabetes among the 5 leading causes for females  Ill-defined causes among the 5 leading causes for males

% Male deaths due to the eight leading underlying causes, by population group,

% Female deaths due to eight leading underlying causes, by population group,

Conclusion Changing underlying mortality patterns over time Changing underlying mortality patterns over time  Differential effects of the changes by:  Gender, Age & Population Group Unspecified unnatural causes dominate Unspecified unnatural causes dominate Emergence of different underlying causes of death Emergence of different underlying causes of death  HIV, TB, and Influenza & pneumonia  Women more likely to die from HIV Decline in unspecified unnatural causes Decline in unspecified unnatural causes  Offset by sharp increase in other underlying causes (HIV, TB, and influenza & pneumonia) Results have implication for policy Results have implication for policy