Media statement

SA Medical Research Council warns about 17 health risk factors that could lead to disease and disability for South Africans

A new publication from the Burden of Disease Research Unit of the South African Medical Research Council (MRC) details a selected group of 17 major risk factors to health. A risk factor is defined as an exposure that increases a person’s chances of developing a disease or disability. For example, cigarette smoking is a risk factor for lung cancer. The goal of the study is to improve and maintain the health of the nation, with an emphasis on preventing disease and injury. The study will be of interest not only to policy-makers, health workers and scientists, but also to the lay public.

Published as a supplement to the August edition of the South African Medical Journal, it follows the first South African National Burden of Disease (SA NBD) study which identified the underlying causes of premature mortality and morbidity experienced in South Africa in the year 2000. In both these studies, disease burden is measured using the disability-adjusted life year (DALY) as the common metric.

The contributions of 17 selected risk factors to the burden of disease in the year 2000 were systematically estimated in terms of death, morbidity and disability. This study, the first of its kind in South Africa, expands the evidence base about the underlying causes of ill-health, and so informs public health priority-setting.  

Professor Anthony MBewu, President of the SA Medical Research Council, comments: “In this manner preventative, health promotive, curative and rehabilitatory interventions can be prioritized and evaluated within the health system at large: between social and economic sectors that affect health and quality of life; and in the daily lives of individuals eager to make healthy personal choices.”

The supplement states that the three leading causes of the burden are sexually transmitted infections (STIs) from unsafe sex (accounting for 31.5% of 16.2 million DALYs in South Africa in 2000), followed by interpersonal violence (8.4% of DALYs) and alcohol harm accounting for 7.0%.  Tobacco accounted for 4.0% of the total DALYs.  It further estimated that the diet-related risk factors such as high body mass index (BMI), high blood pressure and cholesterol, as well as childhood and maternal undernutrition, cause significant harm to health. These attributable burdens are the independent contributions and cannot be added together for risk factors that share common causal pathways.  Risk factors such as unsafe water, sanitation and hygiene and indoor air pollution from household use of solid fuels may also work synergistically with others such as undernutrition or HIV infection to increase incidence and effects of diseases such as respiratory infection and diarrhoeal diseases in children.

Despite health promotion successes in the past, the authors caution that further bold steps and determined action by government are now needed to develop relevant health promotion strategies: “Taking definitive action is not new to our government – as the country’s prominent and courageous anti-tobacco action confirms, as well as the recently adopted National Strategic Plan for HIV, AIDS and STIs.  Preventing or reducing risks to health will have social value far beyond preventing death and disability, including the promotion of sustainable development, reducing inequities in society, and strengthening the trust and legitimacy with which government’s actions are viewed by the citizenry.”