In a follow-up to our previous report on the prevalence of cancer in South Africa, a new thematic report sheds light on the country’s ongoing struggle with non-communicable diseases (NCDs). NCDs, including cardiovascular diseases, diabetes, and chronic lower respiratory diseases, have been a growing concern over the past decade. This report, based on data from Stats-SA’s Mortality and causes of death database, reveals stark trends in mortality due to these NCDs between 2008 and 2018. Understanding these trends is vital for individuals, the financial services sector, insurers, and those concerned with personal finance and health in the nation.

Cardiovascular Diseases Dominate NCD-related Deaths

Over the decade under review, cardiovascular diseases accounted for a significant portion of all NCD-related deaths, consistently representing half of the total. In contrast, chronic lower respiratory diseases, though showing steady growth from 1997 to 2006, saw a decline thereafter, accounting for 10% or less of NCD-related deaths. The most alarming increase was in diabetes-related deaths, more than doubling from 10,846 in 1997 to 26,880 in 2018. Following closely, cancer-related deaths rose by 60%, from 27,052 in 1997 to 43,613 in 2018. Deaths due to cardiovascular diseases increased by 46.5%, reaching 80,133 in 2018. Chronic lower respiratory diseases saw an increase of 47.5% between 1997 and 2006, followed by a 12% drop between 2007 and 2018, possibly attributed to changes in mortality due to TB, a risk factor for CLRD.

Gender Disparities and Median Age

In 2018, females accounted for 54.6% (65,845) of deaths due to the three NCDs, while males accounted for 45.2% (54,556). The median age at death was 65 for males and 69 for females.

Cardiovascular Diseases Age-Standardized Mortality Rates

The age-standardized mortality rate (ASMR) for cardiovascular diseases in 2018 was 173.39 deaths per 100,000 mid-year population, showing a slight decrease from 183.16 per 100,000 in 2008. In 2018, the black African population group had the highest ASMR at 203.46 per 100,000, while the white population group had the lowest at 111.14 per 100,000. Males had higher ASMR at 190.64 per 100,000, compared to females at 158.74 per 100,000 in 2018.

Diabetes Age-Standardized Mortality Rates

The ASMR due to diabetes increased from 58.48 deaths per 100,000 in 2008 to 62.86 deaths per 100,000 in 2018. The Indian/Asian population group had the highest ASMR at 80.79 per 100,000, while the white population group had the lowest and steady ASMR at 20.4 per 100,000.

Chronic Lower Respiratory Diseases Age-Standardized Mortality Rates

The ASMR due to CLRD decreased from 41.4 per 100,000 in 2008 to 31.42 per 100,000 in 2018. The coloured population group had the highest ASMR at 54.1 per 100,000. The white and black African population groups had almost equal ASMR at 25.4 and 24.3 per 100,000, respectively. The Indian/Asian population group had the lowest ASMR of 18.1 per 100,000 in 2018.

Provincial Disparities in NCD Management

Provincial disparities are evident in the management of NCDs, as reflected in both the number of deaths and age-standardized mortality rates. Provinces such as KwaZulu-Natal, Gauteng, Western Cape, and Eastern Cape had the highest number of deaths, partly due to their larger populations. The Free State reported the highest ASMR due to cardiovascular diseases, while Gauteng, Western Cape, Eastern Cape, and Limpopo had the lowest rates.

For diabetes-related deaths, KwaZulu-Natal had the highest ASMR, followed by the Western Cape, although Gauteng reported the lowest ASMR despite having the third-highest number of diabetes-related deaths. Regarding chronic lower respiratory diseases, the Northern Cape had the highest ASMR, while Limpopo had the lowest ASMR. Interestingly, both provinces were among the three with the lowest number of deaths due to CLRD.

These findings underline the need for continued attention to NCDs in South Africa. With the increasing burden of these diseases, there are significant implications for the financial services sector, insurers, and individuals seeking to manage their personal finances. As the country grapples with these health challenges, consumers and financial institutions must adapt to changing healthcare needs and trends to ensure robust financial planning and insurance strategies for a healthier future.