Abstract
The gains in analyzing death from a multiple cause perspective have been recognized for a very long time. Methods that have been adopted have sought to determine additional gains made by treating death as a multiple cause phenomenon as compared to analysis based on a single under-lying cause. This paper shows how association rules mining methodology can be adapted to determine joint morbid causes with strong and interesting associations. Results show that some causes of death that do not appear among the leading causes show strong associations with other causes that would otherwise remain unknown without the use of association rules methodology. Overall, the study found that the leading joint pair of causes of death in South Africa was metabolic disorders and intestinal infectious diseases which accounted for 18.9 deaths per 1000 in 2008, followed by cerebrovascular and hypertensive diseases which accounted for 18.3 deaths per 1000.
Highlights
The analysis and reporting of causes of death continue to be dominated by the single underlying cause of death concept
These conditions account for 71.9% of all coded natural causes and 74.6% of all natural causes coded as Cause A
This paper found that the leading single multiple cause of death in South Africa was TB (A15-A19) followed by ill-defined and unknown causes of mortality (R95-R99), influenza and pneumonia (J10-J18), other forms of heart disease (I30-I52) and intestinal infectious disease (A00-A09)
Summary
The analysis and reporting of causes of death continue to be dominated by the single underlying cause of death concept. As pointed out by [1], the philosophy behind the underlying cause concept is that if the starting point of the sequence of events that lead to death is known, death can be prevented by preventing the initiating cause from operating. The underlying cause of death continues to be coded on death certificates It has been recognised since the first attempts to develop international systems for classification of causes of death that death rarely arises from a single cause [2], especially death caused by chronic pathologies among the elderly [3].
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