SAMJ publishes research on 13-year review of mortality rates among Discovery Health Medical Scheme members

In 2023, the Health Intelligence team at Discovery Health published research into mortality trends over time (from 2010 - 2022) for Discovery Health Medical Scheme (DHMS) members. Our data showed that the COVID-19 pandemic led to the highest death rates ever recorded among DHMS members.

That initial analysis served as the foundation from which Lizelle Steenkamp (Senior Healthcare Statistician) and Shirley Collie (Chief Research Actuary) prepared an updated, comprehensive research manuscript on long-term mortality rates. This work was a collaboration with Professor Glenda Gray (past president of the South African Medical Research Council), Harry Moultrie (Senior Medical Epidemiologist from the National Institute for Communicable Diseases), and Professor Tom Moultrie (Director of the Centre for Actuarial Research).

In July 2024, the South African Medical Journal (SAMJ) published this research. Though the paper focused only on mortality rates among medical scheme members, the data shared was significant because of the absence of recent data on underlying causes of death in South Africa.

This absence of national data is due to a delay in the release of stats - by Stats SA - around causes of death in South Africa. With that in mind, the paper published by the SAMJ is the first to examine the burden of mortality in South Africa, by broad causes of death over a number of years and including the COVID-19 pandemic period.

Key findings reported on in the SAMJ paper:

• In 2022, oncology was the leading cause of death among DHMS members, overtaking cardiovascular-related deaths - which had been the leading cause of death since 2012.
• During 2020 and 2021, the Scheme experienced the highest rate of deaths over the period under review, and this was due to COVID-19.
• Excluding COVID-19 deaths, from 2010 to 2022 there was a reduction across all underlying categories of deaths. 
• Non-communicable diseases had the highest age and sex standardised mortality rate. Here, a 14% decrease (from 429.3 per 100,000 life years to 370.7 per 100,000 life years) was observed from 2010 to 2022.
• HIV/AIDS and tuberculosis had the lowest age and sex standardised mortality rates. A 41% decrease (from 19.6 per 100,000 life years to 11.5 per 100,000 life years) was observed from 2010 to 2022.
• Deaths from communicable diseases, perinatal conditions, maternal causes, and nutritional deficiencies also saw a decrease of 23% between 2010 to 2022.
• Across all causes of deaths, the age- and sex-standardised death rate in 2018 for DHMS members was lower than South African national death rates. The biggest difference was evident in these categories: Communicable diseases, perinatal conditions, maternal causes, and nutritional deficiencies and HIV/AIDS and tuberculosis categories.

Conclusion

Overall, our research found that underlying causes of deaths have remained relatively consistent over the past 13 years. Malignant neoplasms and cardiovascular disease remained the two leading causes of death for DHMS members between 2012 and 2022. The only exception was over 2021 when COVID-19 became the leading cause of death. Diabetes moved from being the eighth-highest cause of death in 2012 to fourth in 2022.

DHMS members experienced higher death rates during 2020 and 2021, the first two years of the COVID-19 pandemic with COVID-19 driving death rates, than in other years in our review period. Specifically, COVID-related deaths accounted for the Scheme's highest death rates ever - recorded in 2021.

Males experienced a higher increase in death rates in 2020 and 2021 (compared to females) and remained at an increased risk of death even in 2022 compared with pre-pandemic levels. Excluding COVID-19 related deaths, in 2022 both females and males experienced death rates lower than pre-pandemic levels.

The lower death rate recorded among DHMS members when compared to the South African population are due to socioeconomic differences between medical scheme member and non-member populations.

• Read the SAMJ publication 'Death trends for 2010 - 2022 for members of a large private medical scheme in South Africa'.

Interested in knowing more or reporting on these findings?

Please contact us on MEDIA_RELATIONS_TEAM@discovery.co.za to request any updated data available since publication and to obtain any further context required.

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Please visit our Discovery Health Insights Hub for a range of analyses and insights shared by our Discovery Health Intelligence Team over the past three and a half years and spanning a variety of health-related themes. All of our COVID-related analyses are posted under our "COVID-19 Insights" pillar.

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