Mortality trends in a new South Africa: Hard to make a fresh start1
Identifieur interne : 001884 ( Pmc/Corpus ); précédent : 001883; suivant : 001885Mortality trends in a new South Africa: Hard to make a fresh start1
Auteurs : Kathleen Kahn ; Michel L. Garenne ; Mark A. Collinson ; Stephen M. TollmanSource :
- Scandinavian journal of public health. Supplement [ 1403-4956 ] ; 2007.
Abstract
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.
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.
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.
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.
Url:
DOI: 10.1080/14034950701355668
PubMed: 17676500
PubMed Central: 2825807
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PMC:2825807Le document en format XML
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<author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name>
<affiliation><nlm:aff id="A1"> MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff>
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<author><name sortKey="Garenne, Michel L" sort="Garenne, Michel L" uniqKey="Garenne M" first="Michel L." last="Garenne">Michel L. Garenne</name>
<affiliation><nlm:aff id="A1"> MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff>
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<affiliation><nlm:aff id="A2"> Institut Pasteur, Paris, France</nlm:aff>
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<author><name sortKey="Collinson, Mark A" sort="Collinson, Mark A" uniqKey="Collinson M" first="Mark A." last="Collinson">Mark A. Collinson</name>
<affiliation><nlm:aff id="A1"> MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</nlm:aff>
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<author><name sortKey="Tollman, Stephen M" sort="Tollman, Stephen M" uniqKey="Tollman S" first="Stephen M." last="Tollman">Stephen M. Tollman</name>
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<author><name sortKey="Garenne, Michel L" sort="Garenne, Michel L" uniqKey="Garenne M" first="Michel L." last="Garenne">Michel L. Garenne</name>
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<affiliation><nlm:aff id="A2"> Institut Pasteur, Paris, France</nlm:aff>
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<author><name sortKey="Collinson, Mark A" sort="Collinson, Mark A" uniqKey="Collinson M" first="Mark A." last="Collinson">Mark A. Collinson</name>
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<series><title level="j">Scandinavian journal of public health. Supplement</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Aims</title>
<p id="P1">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.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">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.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">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.</p>
</sec>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100883504</journal-id>
<journal-id journal-id-type="pubmed-jr-id">22249</journal-id>
<journal-id journal-id-type="nlm-ta">Scand J Public Health Suppl</journal-id>
<journal-id journal-id-type="iso-abbrev">Scand J Public Health Suppl</journal-id>
<journal-title-group><journal-title>Scandinavian journal of public health. Supplement</journal-title>
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<issn pub-type="ppub">1403-4956</issn>
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<article-meta><article-id pub-id-type="pmid">17676500</article-id>
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<article-id pub-id-type="doi">10.1080/14034950701355668</article-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Mortality trends in a new South Africa: Hard to make a fresh start<xref ref-type="fn" rid="FN1">1</xref>
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<contrib-group><contrib contrib-type="author"><name><surname>KAHN</surname>
<given-names>KATHLEEN</given-names>
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<contrib contrib-type="author"><name><surname>GARENNE</surname>
<given-names>MICHEL L.</given-names>
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<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
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<contrib contrib-type="author"><name><surname>COLLINSON</surname>
<given-names>MARK A.</given-names>
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<contrib contrib-type="author"><name><surname>TOLLMAN</surname>
<given-names>STEPHEN M.</given-names>
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<aff id="A1"><label>1</label>
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, South Africa</aff>
<aff id="A2"><label>2</label>
Institut Pasteur, Paris, France</aff>
<author-notes><corresp id="CR1">Correspondence: Dr Kathleen Kahn, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health, Faculty of Health Sciences, 10<sup>th</sup>
floor, University of the Witwatersrand, 7 York Road, Parktown 2193, South Africa. Tel: +27-11-717 2617. Fax: +27-11-717 2084. <email>Kathleen.Kahn@wits.ac.za</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>16</day>
<month>2</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2007</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>22</day>
<month>2</month>
<year>2010</year>
</pub-date>
<volume>69</volume>
<fpage>26</fpage>
<lpage>34</lpage>
<permissions><copyright-statement>© 2007 Taylor & Francis</copyright-statement>
<copyright-year>2007</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Aims</title>
<p id="P1">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.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">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.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">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.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">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.</p>
</sec>
</abstract>
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<funding-group><award-group><funding-source country="United Kingdom">Wellcome Trust : </funding-source>
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<award-group><funding-source country="United Kingdom">Wellcome Trust : </funding-source>
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