title: The unfolding counter-transition in rural South Africa: mortality and cause of death, 1994-2009.
abstract: The HIV pandemic has led to dramatic increases and inequalities in adult mortality, and the diffusion of antiretroviral treatment, together with demographic and socioeconomic shifts in sub-Saharan Africa, has further changed mortality patterns. We describe all-cause and cause-specific mortality patterns in rural South Africa, analyzing data from the Agincourt health and socio-demographic surveillance system from 1994 to 2009 for those aged 5 years and older. Mortality increased during that period, particularly after 2002 for ages 30-69. HIV/AIDS and TB deaths increased and recently plateaued at high levels in people under age 60. Noncommunicable disease deaths increased among those under 60, and recently also increased among those over 60. There was an inverse gradient between mortality and household SES, particularly for deaths due to HIV/AIDS and TB and noncommunicable diseases. A smaller and less consistent gradient emerged for deaths due to other communicable diseases. Deaths due to injuries remained an important mortality risk for males but did not vary by SES. Rural South Africa continues to have a high burden of HIV/AIDS and TB mortality while deaths from noncommunicable diseases have increased, and both of these cause-categories show social inequalities in mortality.
authors: Department of Sociology, University of Washington, Seattle, Washington, United States of America; Institute of Behavioral Science (IBS), University of Colorado at Boulder, Boulder, Colorado, United States of America.
authors: Brian
authors: B
authors: Houle
authors: Department of Sociology, University of Washington, Seattle, Washington, United States of America; Institute of Behavioral Science (IBS), University of Colorado at Boulder, Boulder, Colorado, United States of America; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana; ALPHA Network, London, United Kingdom.
authors: Samuel J
authors: SJ
authors: Clark
authors: MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
authors: F Xavier
authors: FX
authors: Gómez-Olivé
authors: Institute of Behavioral Science (IBS), University of Colorado at Boulder, Boulder, Colorado, United States of America; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Global Health Research, Umeå University, Umeå, Sweden; INDEPTH Network, Accra, Ghana.
authors: Kathleen
authors: K
authors: Kahn
authors: Institute of Behavioral Science (IBS), University of Colorado at Boulder, Boulder, Colorado, United States of America; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Global Health Research, Umeå University, Umeå, Sweden; INDEPTH Network, Accra, Ghana.
authors: Stephen M
authors: SM
authors: Tollman
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D012307:Risk Factors; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult