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. 2007 Aug:69:26-34.
doi: 10.1080/14034950701355668.

Mortality trends in a new South Africa: hard to make a fresh start

Kathleen Kahn  1 , Michel L Garenne, Mark A Collinson, Stephen M Tollman
Affiliations

Mortality trends in a new South Africa: hard to make a fresh start

Kathleen Kahn et al. Scand J Public Health Suppl. 2007 Aug.

Abstract

Aims: This paper examines trends in age-specific mortality in a rural South African population from 1992 to 2003, a decade spanning major sociopolitical change and emergence of the HIV/AIDS pandemic. Changing mortality patterns are discussed within a health-transition framework.

Methods: Data on population size, structure, and deaths, obtained from the Agincourt health and demographic surveillance system, were used to calculate person-years at risk and death rates. Life tables were computed by age, sex and calendar year. Mortality rates for the early period 1992-93 and a decade later, 2002-03, were compared.

Results: Findings demonstrate significant increases in mortality for both sexes since the mid-1990s, with a rapid decline in life expectancy of 12 years in females and 14 years in males. The increases are most prominent in children (0-4) and young adult (20-49) age groups, in which increases of two- and fivefold respectively have been observed in the past decade. Sex differences in mortality patterns are evident with increases more marked in females in most adult age groups.

Conclusions: Empirical data demonstrate a marked "counter transition" with mortality increasing in children and young adults, "epidemiologic polarization" with vulnerable subgroups experiencing a higher mortality burden, and a "protracted transition" with simultaneous emergence of HIV/AIDS together with increasing non-communicable disease in older adults. The health transition in rural South Africa is unlikely to predict patterns elsewhere; hence the need to examine trends in as many contexts as have the data to support such analyses.

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Figures

Figure 1
Figure 1
Trends in life expectancy at birth, Agincourt, 1992–2003.
Figure 2
Figure 2
Relative increase in mortality, Agincourt 2002–03 compared with baseline 1992–93.
Figure 3
Figure 3
Trends in child and younger adult mortality, Agincourt 1992–2003.
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Comment in

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