Mortality trends in a new South Africa: Hard to make a fresh start
Mortality trends in a new South Africa: Hard to make a fresh start
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DOI：
10.1080/14034950701355668
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发表时间：
2007-08-01
影响因子：
3.4
通讯作者：
Tollman, Stephen M.
中科院分区：
文献类型：
--
作者：
Kahn, Kathleen;Garenne, Michel L.;Tollman, Stephen M.
目的：本文研究了 1992 年至 2003 年南非农村人口的特定年龄死亡率的趋势，这十年跨越了重大社会政治变革和艾滋病毒/艾滋病大流行的出现。在健康转型框架内讨论不断变化的死亡率模式。方法：使用从阿金库尔健康和人口监测系统获得的人口规模、结构和死亡数据来计算面临风险的人年和死亡率。生命表是根据年龄、性别和历年计算的。对 1992-93 年早期和十年后 2002-03 年的死亡率进行了比较。结果：研究结果表明，自 20 世纪 90 年代中期以来，男女死亡率均显着上升，女性预期寿命迅速下降 12 岁，男性缩短 14 岁。这一增长在儿童（0-4）和青年（20-49）年龄组中最为显着，在过去十年中分别观察到了两倍和五倍的增长。死亡率模式的性别差异很明显，大多数成人年龄组中女性死亡率的增加更为明显。结论：经验数据表明，随着儿童和年轻人死亡率的增加，出现了明显的“反向转变”；随着弱势群体的死亡率负担较高，出现了“流行病学两极分化”；随着艾滋病毒/艾滋病的同时出现，以及老年人中非传染性疾病的增加，出现了“长期转变”。南非农村地区的健康转型不太可能预测其他地方的模式；因此，需要在有数据支持此类分析的情况下审查尽可能多的趋势。
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.