Spatial patterns and correlates of mortality due to selected non-communicable diseases among adults in South Africa, 2011

South Africa has a high prevalence of non-communicable diseases (NCDs) compared to other African countries. Government has predicted that NCDs will be a major threat of health in the country in the next 20–30 years and recommended a significant reduction in NCDs. This research studies spatial patterns of deaths resulting from chronic lower respiratory diseases (CLRD), malignant neoplasms of digestive organs (MNDO), diabetes mellitus (DM) and cerebrovascular diseases (CVD) among adults aged 15–69 years in 2011 at municipality level. The study uses secondary data from the civil registration system; population census; and supplementary information from the Business Register and a database of public health facilities. Moran’s Index, hot spot analysis and geographically weighted regression were applied to measure spatial autocorrelation of age-standardised death rates; to identify municipalities of high risk of deaths due to selected NCDs; and associated socio-economic and demographic factors. Clusters of high risk of deaths from selected NCDs were identified, with those for CLRD and MNDO mainly in the urban municipalities around the mid and western parts of the country while for DM and CVD they occurred mostly in the urban and rural north-eastern part, as well as in the urban municipalities of Northern Cape for CVD. Hot spots showed differential socio-economic and demographic risk factors in NCDs, which included sex, urbanisation, density of public hospitals; death occurrence in health facilities; smoking; asbestos roofing; mining and quarrying businesses. Findings highlight the importance of community-specific interventions and the need for a neighbourhood-based approach in tackling NCDs.