Health

[a] The five main causes of ill health in the Western Cape are:

• Infectious diseases, including HIV/AIDS and Tuberculosis
• Mental Health conditions
• Injuries, including road traffic injuries and violence-related injuries
• Cardiovascular diseases
• Childhood diseases

However, the Department remains fully dependent on Statistics South Africa (Stats SA) for population-level mortality data. Stats SA published a report in 2018 on mortality and causes of death in South Africa. We are eagerly awaiting the statistical release for deaths that occurred in 2019 to conduct further analysis. The Department is therefore not able to provide answers to the questions beyond 2018 due to limited access to mortality data.

 [b] In the Western Cape we do not focus on leading causes of death as a metric but rather on years of life lost which emphasizes mortality at younger ages. Therefore, the graphs below illustrate the causes of death by the age at which deaths occur. Most deaths in the 15–25-year age group are in boys/men with the major causes being intentional injuries followed by unintentional injuries. These also play a role in the cause of smaller number of female deaths in this age group with HIV/AIDS and tuberculosis being more important especially in the 20–25-year age group in women.

[c] It is very difficult to report on how many deaths would be related to alcohol. If people present to the Emergency Centres, there is no routine blood alcohol testing, and if blood alcohol is done where the South African Police Services [SAPS] are involved it will be via SAPS and not the Health Department. Forensic Pathology Services [FPS] does test for alcohol, but there are delays in receiving toxicology results. In addition, blood alcohol is not necessarily routinely done for all cases. There is additional complexity when considering hospital stays e.g. car accident, admitted to hospital (alcohol not tested), deceased a few days later, and referred to FPS for autopsy as it will be an unnatural death, but too late to test for alcohol.

The 2019 Rapid Review of the Burden of Disease found that from 2010 to 2018:

• there was a year-on-year increase in the annual number of homicides in men, mostly gun-related,
• the rate of homicides due to guns doubled from 2010 to 2016,
• half of homicide victims tested positive for alcohol; 45% had blood alcohol concentration higher than the legal driving limit [0.05g/100ml)]
• 48% of road traffic victims tested positive for alcohol,
• 42% had blood alcohol concentration above legal driving limit [0.05g/100ml].