This report provides information on levels, trends and patterns in mortality and cause-of-death statistics by socio-demographic and geographic characteristics. The mortality indicators and cause of death indicators presented in this report are critical indicators on the health status of the South African population. The main focus is on 2019 death occurrences, however, information on deaths that occurred during the period 1998 to 2018 is included in order to show trends in mortality. The cause-of-death statistics in this statistical release provide information on the leading underlying natural causes of death, patterns and trends in non-natural underlying causes of deaths, as well as comparison between immediate, contributing and underlying causes of death.

Overall, mortality levels are declining in the country as indicated by the downward trend in the number of registered deaths since 2007. The results showed that the total number of deaths registered at the Department of Home Affairs and processed by Stats SA in 2019 were 461 006. While the occurrence of deaths in the country continued to decline it differed by age and sex. The age group 65–69 had the highest proportion of deaths in 2019 at 8,5%, followed closely by age group 60–64 at 8,3%. Conversely, the lowest proportions of deaths were observed in age groups 5–9 years and 10–14 years at 0,6 % and 0,7%, respectively. With regard to sex, between 1997 and 2018, there were more male than female deaths from age 0 to age group 65−69; whereas female deaths consistently exceeded male deaths for ages 70 years and above. 

For province of death occurrence, the highest proportion of deaths (19,8%) occurred in Gauteng province, followed by KwaZulu-Natal and Eastern Cape each comprising 18,6% and 15,7%, respectively. The lowest percentage of deaths occurred in Northern Cape (3,0%), and this was also observed in 2018.

For the period 2016-2018 Tuberculosis remained the main leading cause of death in South Africa, however, in 2019 diabetes mellitus became the leading cause of death. Tuberculosis came in as the second leading underlying cause of death, with its proportion decreasing from 6,1% in 2018 to 5,5%. According to the global burden of diseases, two of the top five leading underlying causes of death for males were communicable diseases (tuberculosis and HIV) whilst among females, were diabetes mellitus and cerebrovascular diseases. The results showed that nine of the ten leading causes of death were the same for both sexes, although with different rankings. Tuberculosis was the leading underlying cause of death for males, accounting for 6,5% of male deaths while diabetes mellitus was the leading underlying cause of death amongst females accounting for 7,5% of female deaths. Human immunodeficiency virus [HIV] disease (4,6%) was the second leading cause of death for the males, followed by cerebrovascular diseases (4,2%). Cerebrovascular diseases (6,0%) was the second leading underlying cause of death for females. In 2019, the most significant decline amongst the underlying causes of deaths were deaths due to other forms of heart diseases which moved from position four in 2018 at 5,0% to position eight in 2019 at 3,4%.

Although the number of deaths due to natural causes were higher than the number of deaths due to non-natural causes, the proportion of deaths due to non-natural cause have been on a slight increase in the past ten years. Between 2009 and 2019, a consistent increase in the proportions of deaths due to non-natural causes was noted from 9,0% in 2009 to 12,4% in 2019. The age groups mostly affected by non-natural causes of death in 2019 were age group 20-24 years and 15-19, accounting for 51,4% and 45,3%, respectively.

Males had higher proportions of deaths due to non-natural causes compared to females, with a wider difference observed at age group 20-24 where 66,3% of male deaths resulted from non-natural causes compared to 23,6% of female deaths in the same age group. Deaths due to non-natural causes were mainly dominated by those due to other external causes of accidental injury (67,2%) followed by assault (20,5%) whilst there were 29,9% non-natural deaths due to transport accidents. In total, KwaZulu-Natal had the highest proportion of deaths due to non-natural causes (14,0%), followed closely by Western Cape (13,6%) and Gauteng (13,1%). In terms of proportions, deaths due to transport accidents were highest in Limpopo (29,9%), whilst assault was highest in Western Cape (20,5%).

This statistical release also addressed quality issues of data on mortality and causes of death from the civil registration system. Maintaining high quality of information is vital for the improvement of the population health status and for monitoring progress towards national, regional and international goals. Future scale up of initiatives aimed at improving death registration and reducing spoiled forms are needed to strengthen completeness and quality of causes of death information in the country.