Preventable deaths among youth in South Africa: Measuring life expectancy in the absence of non-communicable diseases and its implications for the healthcare system.

Abstract

Non-communicable diseases (NCDs) cause premature mortality among youth. Associated with lifestyle and behavioural choices, these diseases and deaths can and should be prevented among young people. This article presents data showing the gains in life expectancy among youth in the absence of NCD causes of death. To estimate the levels of NCD mortality among youth (15 - 24 years of age) in South Africa (SA) and show the current and projected additional years of life gained with the elimination of heart disease, cancer and diabetes. This was a cross-sectional study using 20 years of death notification forms from SA (1997 - 2016). The data were nationally representative and the sample was 62 395 youth deaths (age 15 - 24 years) from the selected NCDs. Cause-specific mortality rates, expressed as percentages, were estimated by age group and sex. Cause-deleted life-table techniques were used to estimate current and projected life expectancy (ex) and life expectancy in the absence of specific NCDs (e-ix). Death rates from NCDs are increasing over time among youth. Total death rates from cancer increased from 1.09% in 1997 - 2001 to 1.51% in 2012 - 2016. Female death rates from heart disease are almost double those for males. The number of additional years of life gained with elimination of these causes ranges from 2.2 to 10.3. Projected life expectancies show that males could gain as much as 1additional year and females 1.06 years by 2035. Urgent action needs to be taken to prevent further mortality from non-communicable causes among youth. The results of this study are important to the SA healthcare system and to public health practitioners whose aim is to reduce the strain on public resources and reduce mortality among youth. Future studies should estimate the extent of NCD mortality in households and communities with the aim of developing macro-level interventions.