Changes in public health in South Africa from 1876.
Open Access
- 1 June 2001
- journal article
- review article
- Published by SAGE Publications in Perspectives in Public Health
- Vol. 121 (2), 85-93
- https://doi.org/10.1177/146642400112100208
Abstract
The present population in South Africa, roughly 43 million inhabitants, is made up of Africans (77.2%), whites (10.5%), Coloureds (mixed race) (8.8%) and Indians (2.5%). In 1900 the infant mortality rate (IMR) among Africans was 330 per 1,000 live births; this has now fallen to 50-60. In Soweto, a primarily African city, IMR averages 20-25. Life expectancy in the past was only 25-30 years; by 1995, this reached 63 years. However, this could fall again due to the rapidly spreading HIV/AIDS epidemic. Life expectancy could fall to 40-45 years by 2010 with the AIDS epidem ic being the cause of half of all deaths - a disastrous change from the pre vious relatively commendable public health situation. Formerly, the most common causes of deaths in young people were infections, diseases asso ciated with malnutrition and gastroenteritis. Adults died almost solely from infections, including typhoid, dysentery, malaria and tuberculosis (TB). Even though diseases associated with malnutrition are less com mon today, many infections still remain a major problem, particularly TB, which is increasing. As late as 1970, Africans who reached 50 years had longer life expectancy than whites due to the low prevalences of the chronic diseases of lifestyle. This is no longer so, due to the recent rises in non-communicable disorders/diseases, principally obesity in women, hypertension, diabetes, stroke and the cancers of prosperity. In the not so distant future, the level of control of HIV/AIDS related diseases will be the major health/disease regulating factor among Africans. Among white, Coloured and Indian populations, there have been falls in the mor tality rates of the young and, despite rises in lifestyle diseases, increases in life expectancy are continuing. For all populations other important pub lic health regulatory factors include water supply, sanitation, clinic/hospi tal services and personal environmental factors, employment, dietary pat tern and intake, smoking practices and alcohol consumption and physical activity, particularly in urban dwellers. Unfortunately, public health expen diture, also a highly regulating factor, has fallen from 8.2% of the gross domestic product in 1994 to 4.1% in 2000.Keywords
This publication has 16 references indexed in Scilit:
- The role of complementary and alternative medicineBMJ, 2000
- UN says up to half the teenagers in Africa will die of AIDSBMJ, 2000
- AIDS cuts life expectancy insub-Saharan Africa by a quarterBMJ, 1999
- Admission trends in a rural South African hospital during the early years of the HIV epidemic.JAMA, 1999
- South Africa to redouble efforts to control the spread of HIVThe Lancet, 1999
- Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort studyThe Lancet, 1999
- Cigarette Smoking and Mortality RiskArchives of Internal Medicine, 1999
- HIV vaccine partnerships offer hope to the developing worldBMJ, 1998
- Human papillomaviruses, cervical cancer and the Developing WorldPathogens and Global Health, 1995
- Does equal socioeconomic status in black and white men mean equal risk of mortality?American Journal of Public Health, 1992