The level of mortality in South Africa in 1985--what does it tell us about health?

South African mortality data are inadequate for health planning. Estimates of mortality levels in blacks for 1985, derived using indirect demographic techniques, have provided an opportunity to analyse South African mortality in a health context. The infant mortality rate (IMR) for the population as a whole was 64/1,000 live births in 1985, which is high when compared with those of other countries. The IMR varied between population groups and was highest in blacks (males 73, females 68) and lowest in whites (males 11, females 7). Adult mortality rates, measured in terms of the chance of a 15-year-old dying before reaching the age of 60, ranged from 42.8% for black males and 29.4% for black females, to 21.8% and 11.5% for white males and females respectively. Life expectancy at birth of black males and females was 55 and 61 years respectively, while for white males and females it was 68 and 76 years respectively. Infectious diseases are a leading cause of death in blacks under 5 years of age, while trauma, poverty-related diseases and chronic diseases related to lifestyle all contribute to the high levels of adult mortality in this group. Prevention and health promotion strategies focusing on these as well as HIV/AIDS must be incorporated in a primary health care strategy to reduce premature mortality. Most importantly, it is crucial to improve the registration system that is vital to facilitate ongoing evaluation.