The biggest killers in South Africa
Stats SA has published its latest Mortality Report for South Africa, revealing that the main causes of deaths in the country in 2024 were due to diabetes, hypertension and strokes.
However, the picture extends beyond the broad data, with non-natural causes of death also ranking high in general, and tuberculosis being particularly fatal among men.
According to Stats SA, the total number of deaths recorded for 2024 was 474,366.
The proportion of male to female deaths was almost the same from infancy until age group 15–19, after which there were more male deaths than female deaths.
The highest number of deaths amongst females was aged 70-74 (9.5%), and for males it was those aged 60-64 at 9.2%.
The lowest number was observed among those aged 5–9 for both sexes 5–9 at 0.6% for males and 0.5% for females.
In line with South Africa’s population distribution, the most populated provinces have the highest proportion of deaths, led by Gauteng (21.2%) and KwaZulu-Natal (18.8%).
The lowest proportion of deaths occurred in the Northern Cape (3.1%).
The top three causes of death in 2024 were due to non-communicable diseases, with diabetes accounting for 6.1% deaths, followed by hypertensive diseases and cerebrovascular diseases at 5.5% and 5.4%, respectively.
Notably, tuberculosis was the leading cause of death amongst males, accounting for 4.8% male deaths, while diabetes mellitus was the leading cause of death amongst females, responsible for 7.9% deaths.
Looking at the leading causes of death, influenza and pneumonia were among the top 10 causes of death across all age groups.
Other forms of heart disease were part of the ten underlying causes of death in all age groups, except for infants.
HIV remains a big killer in South Africa, accounting for 3.8% of deaths. However, this has been declining over the years, dropping from 4.3% in 2022 and 4.0% in 2023.
After being recorded as one of the biggest causes of death in 2020 and 2021, Covid-19 has diminished significantly, with only 450 deaths (<0.1%) recorded in 2024.
Non-natural causes of death
While natural causes of death are the single biggest killers in South Africa, 63,367 people died from non-natural causes.
Most of these deaths are listed under “other external causes of accidental injury”, which accounts for 75% of unnatural deaths, followed by assaults (12%).
The list of accidental injuries is quite broad, with the largest portion (44%) being “accidental exposure to other and unspecified factors”.
The ICD codes associated with these deaths are broad, with code X58 and X59 used when the cause of a fatal injury is unknown.
These codes are used when the fatal injury lacks the necessary details to properly classify the cause of death. Both codes are a ‘catch-all’ for unknown causes.
Among the accidental injuries, the first clear cause is “exposure to inanimate mechanical forces”, which covers a very wide range of causes, including gunshots.
It also covers other accidents, such as explosions, falling objects, foreign objects penetrating a body, and contact with a variety of sharp objects.
Stats SA acknowledged the trouble with the broad classifications, saying that more work needs to be done to better define causes of death.
“Although improvements have been made in the reporting of causes of death and completeness of death
registration, further improvements are needed in the reduction of unspecified and unknown cases,” it said.
This applies to both the natural and non-natural causes. For natural causes, symptoms and signs not elsewhere classified accounted for 18.2% of deaths in 2024.
“High levels of ill-defined causes make it impossible to monitor, evaluate, or compare disease trends over time,” Stats SA said.
“It also creates a distorted view of the health status of a population, often masking the true leading causes of death.”
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