Key findings: P0309.3 – Mortality and causes of death in South Africa, 2020: Findings from death notifications

This report provides information on levels, trends and patterns in mortality and cause of death by socio-demographic and geographic characteristics. The mortality and cause of death indicators presented in this report are critical for measuring the health status of the South African population. The main focus of this report is on 2020 death occurrences, however, information on deaths that occurred during the period 1999 to 2019 is included to show trends in mortality.

The total number of deaths recorded for 2020 was 489 744. Overall, a 22-year trend shows that between 1999-2003 and 2010-2020, non-communicable diseases accounted for a large percentage of deaths; although a slight decline in these proportions was observed beginning 2019. Conversely, there has been a slight increase in the number of deaths linked to communicable diseases since 2019.

The occurrence of deaths differed by age and sex in 2020. The age group 65–69 years, had the highest proportion of deaths at (9,3%), while the age group 5-9 years had the lowest at (0,5%). Disaggregation by sex shows that between 1999 and 2020, there were more male deaths than female deaths from age 0 to age group 65−69; whereas female deaths exceeded male deaths from age 70 years and above. The median age at death was 56,5 years for males and 64,0 years for females. The results further indicate that in the past five years, 2019 had the highest death sex ratio (186 male deaths per 100 female deaths) observed, which was for age group 20−24 years. The provinces with the highest proportion of deaths were Gauteng (22,2%), KwaZulu-Natal (19,3%) and Eastern Cape (15,9%). The province with the lowest percentage of deaths was Northern Cape (3,1%).

The leading cause of death in South Africa in 2020 was COVID-19 at 6,7%. Ranking second and third were diabetes mellitus (6,6%) and cerebrovascular diseases (5,5%). The top ten leading causes of death were the same for both sexes, although with different rankings. COVID-19 (6,4%), diabetes mellitus (5,0%) and tuberculosis (4,9%) were the leading underlying cause of death for males. Whereas diabetes mellitus (8,2%), COVID-19 (7,0%) and hypertensive diseases (6,5%) were the leading underlying causes for females. The most notable movement among the underlying causes of death was seen in tuberculosis, which dropped from second place in 2019 to sixth place in 2020.

Deaths due to non-natural causes were higher for males than females, with the proportion significantly high for males aged 20-24 years. Assault (12,0%), transport accidents (9,7%) and event of undetermined intent (5,5%) were the three leading non-natural causes of death in the country in 2020. Kwa-Zulu Natal had the highest percentage of deaths due to external causes of death and injuries at 11,2% followed by Western Cape (10,5%) and Gauteng (9,8%).