1. Causes of Death in South Africa 1997-2001 Advance release of recorded causes of death Launch Presentation 21 November 2002

2. 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

3. 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

4. Aims of the present study Complement the earlier reports Complement the earlier reports Identify leading underlying causes of death for period 1997-2001 Identify leading underlying causes of death for period 1997-2001 Identify emerging cause of death trends & patterns during the period Identify emerging cause of death trends & patterns during the period

5. Data & methods Based on 12% stratified random sample Based on 12% stratified random sample  Death notification forms from DHA  For period 1997-2001  To expedite release of information on causes of death  279 581 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

6. Leading underlying causes of death for both males and females, 1997-2001 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

7. Percentage of deaths due to the leading underlying causes by year of death,1997-2001

8. Changing importance of leading underlying causes of deaths for both males and females, 1997 & 2001 Cause19972001 %Rank%Rank Unspecified unnatural causes 15.318.24 Ill-defined causes 8.628.63 TB6.539.71 HIV4.648.72 Influenza & pneumonia 4.557.95

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

10. Percentage distribution of deaths due to leading underlying causes by gender,1997-2001

11. Changing importance in the leading underlying causes of male deaths, 1997 & 2001 97-01%Change19972001 %Rank%Rank TB9.1+457.5310.92 HIV6.5+953.957.64 Influenza & pneumonia 5.8+764.147.25 Ill-defined8.2+18.528.63 Unnatural15.6-4220.8112.11 Total45.241.846.4

12. Changing importance of the leading underlying causes of female deaths, 1997 & 2001 97-01%Change19972001 %Rank%Rank TB6.7+625.248.44 HIV8.5+755.639.81 Influenza & Pneumonia 6.9+715.158.72 Ill-defined8.28.718.63 Cerebrovascular7.6-67.927.45 Total37.932.542.9

13. 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

14. % Male deaths due to the leading underlying causes of death by age, 1997-2001

15. % Female deaths due to the leading underlying causes by age, 1997-2001

16. 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

17. % Male deaths due to the eight leading underlying causes, by population group, 1997-2001

18. % Female deaths due to eight leading underlying causes, by population group,1997-2001

19. 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