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Statistics SA: The swings and roundabouts of how we die

cemetery at nightIn 2016 women in South Africa were 36% more likely to die from diabetes than from the combination of car accidents, violent crime, suicide, and all other 'non-natural' causes, reports Statistics SA. On the other hand, over 70% more males than women were killed in car accidents.

Diabetes was identified as the underlying cause of death for a record 15,506 women in 2016, Statistics SA said. A total of 11,423 women were found to have died from "non-natural" causes, mostly from accidents, crime, and suicide.

The number of non-natural deaths for women declined slightly between 2015 and 2016, but diabetes deaths have been steadily increasing for years, both in absolute numbers and as a percentage of total deaths. The report says diabetes is far and away the leading killer of women in SA now, responsible for 16% more deaths than the number two cause, cerebrovascular diseases – and 46% more deaths than HIV.

The numbers are vastly different for men, who are much more likely to die from non-natural causes than from disease. In 2016 there were 3.5 non-natural deaths among men for every non-natural death for women. The number of non-natural deaths among men were almost the same as the three leading natural causes for death put together: tuberculosis, HIV, and a grab-bag of heart diseases excluding the most common, such as high blood pressure.

Nearly 60% more women than men died of diabetes in 2016.

 

More than 3,000 boys and men between the ages of 15 and 44 were killed in car accidents in 2016, while just over 900 women in the same age category were killed in car accidents. "The distribution of non-natural causes of death by sex in 2016 showed that there were 39 395 male deaths, 71.1% higher than the 11 402 deaths observed among females," News24 reports Stats SA said.

Among both men and women, the top natural causes of death included tuberculosis, HIV diseases, influenza and pneumonia, diabetes mellitus, cerebrovascular diseases, other viral diseases, chronic lower respiratory diseases, hypertensive diseases, ischaemic heart diseases and other forms of heart disease.

The report said the National Development Plan (NDP) adopted by South Africa envisioned life expectancy to increase from the low 60s to at least 70 years of age and a largely HIV-free population below 20 years of age.

"South Africa adopted the UN Sustainable Development Goals (SDGs) that are also founded on leaving no one behind in health. Goal three of the SDGs aims to improve maternal and child health outcomes, end infectious diseases, reduce premature mortality from non-communicable diseases and injuries and ensure universal health coverage by 2030," the report said.

"Both the NDP and the SDGs are closely linked to Africa's Agenda 2063 which is a long-term inclusive and sustainable development framework for Africa.

"The agenda envisages a continent characterised by universal access to healthcare, zero communicable deaths, zero maternal deaths, zero child deaths and countries capable of mobilising domestic funding for preventing, detecting and responding to public health threats such as non-communicable diseases, health needs of the youth population and malnutrition by 2063."

The report said information on the number of deaths and their causes was invaluable. "The information on the mortality levels, trends and differentials is important for the identification of emerging diseases and conditions, formulation of evidence-based health policies and tracking of the population health status," it said.

 

The Times reports that the Stats SA analysed the 456,612 deaths recorded in 2016. Of these‚ 240,001 were men and 214,988 were women‚ or 112 males for every 100 female deaths. In addition, 1,623 were listed as gender unspecified. The total amount was a decline from the 473,266 deaths in 2015.

The age group within which most men died was 60-64 years old (8.6%) while most females died between 75 and 79 years old (8.3%).

In 2016 most deaths occurred in the country’s most populous provinces Gauteng (21.3%) and KwaZulu-Natal (18.6%).

Just more than one in every five deaths occurred at home (22‚6%). “It is worth noting that a high proportion of deaths continue to occur at home instead of in healthcare facilities‚ and this may impact on the accuracy of the certification of causes of death‚” said Stats SA.

The report says the top 10 killers in South Africa are: ill-defined and unknown causes of mortality – 57,159 (12.5%); other external causes of accidental injury (includes drowning‚ smoke inhalation‚ poisoning) – 34,096 (7.5%); tuberculosis – 29,513 (6.5%); diabetes – 25,255 (5.5%); other forms of heart disease (includes pericarditis‚ endocarditis‚ pulmonary valve disorders‚ cardiac arrest‚ atrial fibrillation) – 23,515 (5.2%); cerebrovascular diseases – 23,137 (5.1%);HIV – 21,830 (4.8%); hypertensive diseases – 19,960 (4.4%); influenza and pneumonia – 19,638 (4.3%); and other viral diseases (includes cytomegaloviral disease‚ mumps‚ infectious mononucleosis‚ viral conjunctivitis) – 16,577 (3.6%).

 

Tuberculosis remained the leading cause of death in the three-year period from 2014 to 2016, although the proportion of deaths owing to the disease declined in the same period from 8.3% to 6.5%, says a Huffington Post report.

Diseases of the circulatory system were the most common underlying cause of death in 2016, comprising 18.5%. "This group has overtaken certain infectious and parasitic diseases in 2016… Diseases of the respiratory system and neoplasm were the third and fourth most common main group of underlying causes responsible for 9.4 percent and 9.3 percent, respectively."

The report says Stats SA identified other trends: a general observation is that age groups 30–34 years to 75–79 years each represented more than 6 percent of all deaths; from 2006 to 2016, the proportions of male deaths increased consistently while a downward trend was observed among female deaths – during this period, the proportion of male deaths increased from 50.7% in 2006 to 52.7% in 2016. Female deaths decreased steadily from 49.3% in 2006 and reached 47.3% in 2016; the magnitude of the gap between male and female deaths widened from a 1.4 percentage points excess male deaths in 2006 to a 5.4 percentage points excess male deaths in 2016.

[link url="http://www.statssa.gov.za/publications/P03093/P030932016.pdf"]Stats SA report[/link]
[link url="https://www.businessinsider.co.za/Life/diabetes-now-kills-more-women-by-far-than-non-natural-causes-2018-3"]Business Insider report[/link]
[link url="https://www.news24.com/SouthAfrica/News/higher-rate-of-unnatural-deaths-among-men-statssa-20180327"]News24 report[/link]
[link url="https://www.timeslive.co.za/news/south-africa/2018-03-27-killers-here-are-the-top-10-things-most-south-africans-die-from/"]The Times report[/link]
[link url="https://www.huffingtonpost.co.za/2018/03/27/diabetes-second-biggest-killer-behind-tb-in-south-africa_a_23396419/"]Huffington Post report[/link]

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