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.
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.
Authors: D A Leon; L Chenet; V M Shkolnikov; S Zakharov; J Shapiro; G Rakhmanova; S Vassin; M McKee Journal: Lancet Date: 1997-08-09 Impact factor: 79.321
Authors: Kathleen Kahn; Stephen M Tollman; Mark A Collinson; Samuel J Clark; Rhian Twine; Benjamin D Clark; Mildred Shabangu; Francesc Xavier Gómez-Olivé; Obed Mokoena; Michel L Garenne Journal: Scand J Public Health Suppl Date: 2007-08 Impact factor: 3.021
Authors: James R Hargreaves; Mark A Collinson; Kathleen Kahn; Samuel J Clark; Stephen M Tollman Journal: Int J Epidemiol Date: 2004-08-19 Impact factor: 7.196
Authors: Kathleen Kahn; Stephen M Tollman; Mark A Collinson; Samuel J Clark; Rhian Twine; Benjamin D Clark; Mildred Shabangu; Francesc Xavier Gómez-Olivé; Obed Mokoena; Michel L Garenne Journal: Scand J Public Health Suppl Date: 2007-08 Impact factor: 3.021
Authors: Elizabeth W Kimani-Murage; Kathleen Kahn; John M Pettifor; Stephen M Tollman; David B Dunger; Xavier F Gómez-Olivé; Shane A Norris Journal: BMC Public Health Date: 2010-03-25 Impact factor: 3.295
Authors: Jill R Williams; Enid J Schatz; Benjamin D Clark; Mark A Collinson; Samuel J Clark; Jane Menken; Kathleen Kahn; Stephen M Tollman Journal: Glob Health Action Date: 2010-08-31 Impact factor: 2.640
Authors: Benn Sartorius; Kathleen Kahn; Penelope Vounatsou; Mark A Collinson; Stephen M Tollman Journal: Glob Health Action Date: 2010-08-30 Impact factor: 2.640
Authors: F Xavier Gómez-Olivé; Margaret Thorogood; Benjamin D Clark; Kathleen Kahn; Stephen M Tollman Journal: Glob Health Action Date: 2010-09-27 Impact factor: 2.640