Index. Research Objective. Health Issues in SA Non-communicable diseases Diabetes Cancer Hypertension. Communicable Diseases HIV AIDS TB

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Index Research Objective Health Issues in SA Non-communicable diseases Diabetes Cancer Hypertension Communicable Diseases HIV AIDS TB Obesity & Weight Loss Customer Segmentation Competitive Environment To investigate illnesses in South Africa across ages, race & province Identify target groups for Gluco-Less Foundation for brand positioning & strategy Sources World Health Organisation General Household Survey 2011 National Cancer Registry 2004 SA Medical Research Council South African Demographic & Health Survey

Health in South Africa Overview of causes of death & health issues in South Africa

Causes of Death by Province Diabetes is in top 10 causes for death in Gauteng & KZN Leading Causes of Premature Death by Province by % HIV/AIDS South Africa Western Cape North West Northern Cape Mpumalanga Limpopo KwaZulu Natal Gauteng Free State Eastern Cape 39 4,2 4,7 6,8 3,9 3,7 2,8 1,51,72,5 Diarrhoeal Diseases Tuberculosis Homicide/Violence Lower Respiratory Infec on Road Traffic Stroke Protein-energy malnutri on Low Birth Weight COPD Ischaemic Heart Disease Suicide Diabetes Mellitus 0 10 20 30 40 50 60 70 80 90 Hypertensive Heart Disease COPD: Chronic Obstructive Pulmonary Disease Ischaemic Heart Disease: Constricted blood vessels which causes strokes & heart attacks Trachea/bronchi/lung Source: WHO

Health Issues Adult Risk Factors HIV & Respiratory diseases are the main causes of premature death, followed by heart & stroke Communicable diseases such as Diabetes & Hypertension are becoming more of a health risk Diabetes is in the top 10 causes of death in Gauteng & KwaZulu Natal Diseases as a result of poor lifestyle are becoming more prevalent in SA There are more obese people in SA than there are smokers! Health risk factors for South African Adults Obesity & High Blood Pressure are the most prevalent adult risk factors Source: WHO

Non-communicable Diseases Diabetes, Hypertension & Cancer

Diabetes in South Africa The diabetes tsunami is here. And we in South Africa are in trouble." Dr Larry Distiller, founder and managing director of the Centre for Diabetes and Endocrinology "Three-and-a-half million South Africans (about 6% of the population) suffer from diabetes and there are many more who are undiagnosed," he cautions. It is estimated that another five million South Africans have prediabetes, a condition where insulin resistance causes blood glucose levels to be higher than normal, but not high enough yet to be type 2 diabetes. Approximately 85-90% of all people with diabetes are type 2, and many people who have this condition are undiagnosed. Type 1 diabetics are 0,7% of the population (approximately 350 000). Most type 1 diabetics are diagnosed before the age of 40, with the peak age of incidence being 14.

Diabetes by 16 14 14 Demographic Profiles 4,7% of those in the General Household Survey had been told they had diabetes Diabetes is more prevalent in older age groups (55+) and in Females Indian & Coloured groups are more genetically predisposed to develop diabetes Percentage 12 10 8 6 4 2 0 11,7 6,1 4,7 5,2 4,1 1,9 0,5 South Africa 25-34 35-44 45-54 55-64 65+ Female Male Source: General Household Survey, 2011

Diabetes by Province Top provinces for Diabetes are Western Cape & KwaZulu Natal Gauteng % is lower than the national average Source: General Household Survey, 2011

Hypertension in South Africa Hypertension, or high blood pressure, is known as the silent killer in South Africa and is a leading cause for heart attacks & strokes It is estimated 25% of the population over 25 have hypertension/high blood pressure. Hypertension is common is South Africa and is a risk factor for heart attacks, stroke, left ventricular hypertrophy, renal disease & blindness People who have hypertension are usually unaware that they have the condition, unless the BP has been measured at health-care facilities. It is therefore frequently referred to as a silent epidemic in South Africa. Hypertension frequently co-exists with other risk factors for chronic diseases of lifestyle (CDL), such as diabetes and obesity

Hypertension by Demographic Profiles 14% of those in the General Household Survey had been told they had hypertension Hypertension risk increases significantly with age Hypertension is more prevalent in females Hypertension affects the white & coloured population groups Source: General Household Survey, 2011

Hypertension by Province Top provinces for Hypertension are Eastern Cape, Northern Cape & North West Source: General Household Survey, 2011

Cancer in South Africa Cancer diagnoses in SA are expected to double by 2030 One in six South African men and one in seven South African women will get cancer during their lives. If figures released by the International Agency for Research in Cancer (IARC), published in CA: A Cancer Journal for Clinicians, are anything to go by, it is essential that SA increases its spend on cancer prevention, treatment and awareness. According to the IARC, approximately 681 000 new cancer cases and 512 400 cancer deaths were reported in Africa in 2008. These numbers are projected to nearly double to 1.28 million new cancer cases and 970 000 cancer deaths by 2030, due to ageing and growth in the population.

Cancer by Demographic Profiles O.5% of those in the General Household Survey had been told they had Cancer & there were no further figures to report 2004 Cancer Registry shows that 51% of all Cancer patients are Female, with 49% Male Cancer patients are mostly white, although Black females also make up a large proportion Source: National Cancer Registry

Cancer Types by Gender Most prevalent type of Cancer in men is prostrate & lung Most prevalent type of cancer in women is breast & cervical Colon cancers are more likely to occur in people with sedentary lifestyles, obese people, and those who smoke tobacco. Cancer and the South African man The cancers affec ng all South African men, in order of prevalence, are: Prostate cancer Lung cancer Oesophageal cancer Bladder cancer Colo-rectal cancer Cancer and the South African woman The cancers affec ng all South African women, in order of prevalence, are: Breast cancer Cervical cancer Colo-rectal cancer Lung cancer Oesophageal cancer Source: National Cancer Registry

Communicable Diseases HIV/AIDS & Tuberculosis

HIV/AIDS in South Africa The estimated overall HIV prevalence rate is approximately 10%. The infection rate amongst adults in 18,1% (UNAIDS Report, 2011). The total number of people living with HIV is estimated at approximately 5,26 million in 2013. South Africa has more people living with HIV/AIDS than any other country in the world

HIV/AIDS by Demographic Profiles 1,7% of those in the General Household Survey said that they had HIV/AIDS HIV/AIDS is more prevalent in women & age groups 30 44 HIV/AIDS mostly affects the black population Source: General Household Survey, 2011

HIV/AIDS by 3 Province 2,5 2,5 2,5 2,2 2,2 2,2 2 UNAIDS data places adult infection rate at 18,1% amongst sexually active adults Percentage 1,5 1 1,7 1,4 1,4 0,7 0,7 KZN is the worst province for HIV infection, followed by Mpumalanga & Free State Western Cape has the lowest infection rate 0,5 0 South Africa North West KwaZulu Natal Eastern Cape Free State Mpumalanga Northern Cape Province Gauteng Western Cape Limpopo 30,00% 25,8% 25,00% 23,1% 20,00% 18,1% 18,5% 17,7% 15,00% 15,2% 15,2% 13,7% 10,00% 9,2% 5,00% 5,3% 0,00% SA Average (Adult) KwaZulu-Natal Mpumalanga Free State North West Gauteng Eastern Cape Limpopo Northern Cape Western Cape Source: General Household Survey, 2011 & UNAIDS Regional Summary

Tuberculosis in South Africa South Africa is ranked third in the world for the highest TB infection rate, and more than half of all TB Patients are HIV positive WHO health profile of South Africa 768 per 100 000 of population has TB (compared to 170 worldwide) South Africa is faced with a dual HIV-TB epidemic where the high rate of HIV infection is fuelling the tuberculosis or TB epidemic In addition to this, increasing numbers of people are becoming infected with drug-resistant TB strains, says Dr Bavesh Kana Head of the Wits University node of the DST/DRF Centre of Excellence for Biomedical TB Research Source: WHO & Health24.com

TB by Demographic Profiles 2,9% of those in the General Household Survey said that they had TB TB is more prevalent in men & age groups 25 44 TB is most prevalent in the black population Source: General Household Survey, 2011

TB by Province KZN has significantly higher infection rate than other provinces Source: General Household Survey, 2011

Obesity & Weight Loss Obesity & BMI figures in South Africa Perceptions of Weight Loss amongst South Africans

Obesity in South Africa Almost half of South Africans over the age of 15 are overweight or obese The most recent statistics from the SA Medical Research Council showed that 70% of adult women over the age of 35 were overweight or obese and that black women were exposed to the greatest risk, with 33% being obese. These figures are frightening because they are predictors of the burden of lifestyle diseases such as type 2 diabetes, hypertension, strokes, certain types of cancer and heart disease that our country will have to cope with in years to come. Source: SA Medical Research Council

Obesity in Males Highest levels of obesity & being overweight in older males (35+) Highest levels of obesity in white males Highest levels of being overweight in Indian males Source: South African Demographic & Health Survey

Obesity in Males Highest levels of obesity & being overweight in males with a higher education Highest levels of obesity in Western Cape & Gauteng Highest levels of being overweight in KZN, Western Cape & Gauteng Profile of overweight or obese men in SA is white/indian, educated & living in Gauteng, Western Cape & KZN Source: South African Demographic & Health Survey

Obesity in Females Obesity levels far more prevalent in females than in males Highest levels of obesity & being overweight in females over 35 (become obese younger than males) Urban African women have the highest levels of obesity, followed by Coloured & Indians Source: South African Demographic & Health Survey

Obesity in Females Highest levels of obesity in women with education level Grades 6-7 Highest level of obesity in women from Gauteng & Western Cape KZN has the highest level Profile of overweight women in SA is black, uneducated & living in urban areas in Gauteng & Western Cape Source: South African Demographic & Health Survey

Perceptions about weight & weight loss Females are more likely to be unhappy with their current weight Females are more likely to try & lose weight than males Happiness with current weight Overall significantly more males (69.2%) than females (63.3%) were happy with their current weight and fewer males (13.3%) than females (18.1%) were unhappy with their current weight. Attempts to lose or gain weight in the last 12 months Overall, significantly more South Africans (11.5%) attempted to lose weight than gain weight (8.6%) over the last 12 months. There were no significant gender differences among those who attempted to gain weight, however significantly more females (14.6%) attempted to lose weight than males (8.0%). Source: South African Demographic & Health Survey

Summary of Medical Conditions in SA Medical Condition Diabetes Pre-diabetes Estimated Nationwide % 6% 10% Age Group Race Gender Province 65+ Indian & Coloured Female Western Cape & KZN Hypertension 25% 65+ White & Coloured Female Eastern Cape & Northern Cape Cancer 1 in 6 (16%) unknown White Male & Female unknown HIV/AIDS 10% 30-34 Black Female North West & KZN Tuberculosis 1 in 120 (1%) 45-54 Black Male KZN Obesity (Male) 45% 65+ White Male Gauteng, KZN Obesity (Female) 50% 45-54 Black Female Western Cape, Eastern Cape, KZN