Our lifestyles are increasingly killing us, says Stats SA report

Deaths due to chronic medical conditions including cardiovascular, cancer, diabetes and chronic lower respiratory diseases have increased 58.7% over 20 years, Stats SA says.

In a report released on Tuesday, the agency said these chronic conditions, referred to as non-communicable diseases (NCDs), require targeted interventions to ease the burden on health systems.

Factors such as urbanisation, sedentary lifestyles, unhealthy dietary habits such as too much salt, high sugar intake and fatty foods, inadequate intake of fibre, fruit and vegetables, tobacco use and rising obesity rates have contributed to this upsurge, according to World Health Organisation research. Detection, screening and treatment of NCDs are key components of the response to this health challenge.

Looking at data between 1997 and 2018, Stats SA said the median age of death was 65 for males and 69 for females.

Deaths due to cardiovascular diseases (heart attacks and strokes) increased steadily between 2008 to 2018, accounting for 12.9% in 2008, and increasing to 17.6% in 2018. Black Africans had the highest age-standardised mortality rates at 203.46 per 100,000, followed by Indian/Asian and coloured population groups, at 170.63 and 168.23 per 100,000 respectively. The white population group had the lowest age-standardised mortality rates overall, at 111.14 per 100,000 in 2018.

A leading risk factor for cardiovascular diseases is hypertension, or high blood pressure. It is reported that South Africa has one of the highest levels of overweight and obesity in the world, which is a contributing factor for heart disease.

The number of deaths due to diabetes increased by 36.5% in the period. In 2018, the age-standardised mortality rate for diabetes was 62.86 deaths per 100,000 midyear population. The Indian/Asian population group had the highest, while the white population group had the lowest. The coloured and black African population groups had lower but increasing age-standardised mortality rates than the Indian/Asian population group.

Chronic lower respiratory diseases accounted for 2.4% of all causes of mortality in 2008, and their contribution increased to 3% in 2018. Chronic obstructive pulmonary diseases accounted for the majority at 62%, followed by asthma at 22.3% and status asthmaticus at 5.4%. Males accounted for the majority of deaths at 60.2%. Contributing factors include smoking, TB and exposure to indoor smoke from solid fuels. 

Cancer-related deaths increased by 29.3% between 2008 and 2018, according to a separate report released in March by Stats SA. Among males, the most diagnosed cancers were those of the prostate, colorectal and lung. Among females, the most diagnosed cancer was breast cancer.

KwaZulu-Natal, Gauteng, the Western Cape and Eastern Cape have some of the highest number of deaths due to NCDs.

“This may be a reflection of their large populations, as they host almost two-thirds of the population of South Africa. However, their age-standardised mortality rates are substantially different. This may be due to differences in access to health services or quality of the services provided.

“The Free State has one of the lowest number of NCD-related deaths in absolute numbers, but some of the highest mortality rates,” the report found.

Efforts to tackle NCDs have evolved, with a notable shift towards preventive strategies, Stats SA said.

“Health education campaigns, policy interventions and public health initiatives focusing on promoting a healthier lifestyle, early detection and regular health check-ups have shown promise in curbing the spread and impact of NCDs.

“Regular screening for NCDs at health facilities needs to be reinforced to ensure timely diagnosis and monitoring of patients to ensure that they are under control.”

The South African National Strategic Plan for the Prevention and Control of Non-Communicable Diseases, 2022—2027, aims to strengthen health systems to accelerate the prevention and control of these chronic conditions.

Stats SA said it hoped the research would enable the formulation of targeted interventions, allocate resources appropriately, and implement programmes to create awareness about the risk factors associated with chronic conditions.

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