Key Findings

This thematic report is a follow up to a previous one, Report No: 03-08-00, Cancer in South Africa (2008-2019). The purpose of the current report is to describe trends in mortality due to the other, major non-communicable diseases (NCD), vis-a-vis, cardiovascular diseases, diabetes and chronic lower respiratory diseases between 2008 and 2018. Information used to compile this report was obtained from the Stats-SA’s Mortality and causes of death data. It covers number of people who died from the three noncommunicable diseases, their distribution by sex, age, population group and mortality rates.

Over all years in the series, cardiovascular diseases accounted for half of all the NCD-related deaths while chronic lower respiratory diseases accounted for the lowest, at 10% or less. With the exception of deaths due to chronic lower respiratory diseases, which increased steadily from 1997 to 2006, and declined thereafter, all other deaths due to NCDs showed an increasing trend. The highest increase was for diabetes-related deaths, which more than doubled, increasing from 10 846 in 1997 to 26 880 in 2018. They were followed by cancer-related deaths, which increased by 60%, from 27 052 in 1997 to 43 613 in 2018. Deaths due to cardiovascular diseases increased by 46,5%, from 54 701 in 1997 to 80 133 in 2018. Deaths due to CLRD increased by 47,5% between 1997 and 2006, from 10 829 to 15 971, followed by a 12% drop between 2007 and 2018, from 15 433 in 2007 to 13 579 in 2018. As elaborated in the report, this change may be due to changes in mortality due to TB, a risk factor for CLRD. TB dropped significantly following the roll-out of ARVs in 2006, and the implementation of WHO-recommended guidelines for integrated management of TB and HIV.

In 2018, females accounted for 54,6% (65 845) of deaths due the three noncommunicable diseases, while males accounted for 45,2% (54 556). The median age at death in years was 65 for males and 69 for females.

Cardiovascular diseases age-standardised mortality rates:

The age-standardised mortality rate (ASMR) in 2018 was 173,39 deaths per 100 000 mid-year population, a small decrease from 183,16 per 100 000 in 2008. In 2018, the black African population group had the highest ASMR at 203,46/100 000 while the white population group had the lowest, at 111,14/100 000. Males had higher ASMR at 190,64/100 000, compared to females at 158,74/100 000 in 2018.

Diabetes age-standardised mortality rates:

The ASMR due to diabetes was 62,86 deaths per 100 000 in 2018, an increase from 58,48 deaths per 100 000 in 2008. In 2018, the Indian/Asian population group had the highest ASMR at 80,79/100 000, while the white population group had the lowest and steady ASMR at 20,4/100 000.

Chronic lower respiratory diseases age-standardised mortality rates:

The ASMR due to CLRD was 31,42 deaths per 100 000 in 2018, a decrease from 41,4 per 100 000 in 2008. The coloured population group had the highest ASMR at 54,1/100 000. The white and black African population groups had almost equal ASMR at 25,4/100 000 and 24,3/100 000 respectively. The Indian/Asian population group had the lowest ASMR of 18,1/100 000 in 2018.

Provincial comparisons

There were substantial differences between provinces in terms of management of non-communicable diseases, as reflected in number of deaths and age-standardised mortality rates. KZN, Gauteng, WC and EC had the highest number of deaths, but this likely due to the fact that these provinces have the largest populations. The Free State had the highest ASMR due to cardiovascular diseases, while Gauteng, Western Cape, Eastern Cape and Limpopo had the lowest.

For diabetes-related deaths, KZN had the highest ASMR, followed by the WC. While Gauteng was third-highest in terms of number of diabetes-related deaths, it had the lowest ASMR. For chronic lower respiratory diseases, the Northern cape had the highest ASMR while Limpopo had the lowest ASMR. Both provinces were, however, among the three provinces with the lowest number of deaths due to CLRD.