Browsing by Author "Parry, C."
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- ItemEstablishing a health promotion and development foundation in South Africa(Health and Medical Publishing Group (HMPG), 2013-03) Perez, A. M.; Ayo-Yusuf, O. A.; Hofman, K.; Kalideen, S.; Maker, A.; Mokonoto, D.; Morojele, N.; Naidoo, P.; Parry, C.; Rendall-Mkosi, K.; Saloojee, Y.South Africa has a ‘quadruple burden of disease’. One way to reduce this burden, and address the social determinants of health and social inequity, could be through health promotion interventions driven by an independent Health Promotion and Development Foundation (HPDF). This could provide a framework to integrate health promotion and social development into all government and civil society programmes. On priority issues, the HPDF would mobilise resources, allocate funding, develop capacity, and monitor and evaluate health promotion and development work. Emphasis would be on reducing the effects of poverty, inequity and unequal development on disease rates and wellbeing. The HPDF could also decrease the burden on the proposed National Health Insurance (NHI) system. We reflect on such foundations in other countries, and propose a structure for South Africa’s HPDF and a dedicated funding stream to support its activities. In particular, an additional 2% levy on alcohol and tobacco products is proposed to be utilised to fund the HPDF.
- ItemEstimating the burden of disease attributable to alcohol use in South Africa in 2000(Health & Medical Publishing Group, 2007) Schneider, M.; Norman, R.; Parry, C.; Bradshaw, D.; Pluddemann, A.Objectives. To make quantitative estimates of the burden of disease attributable to alcohol use by sex and age group in South Africa in 2000. Design. The analysis follows the World Health Organization comparative risk assessment (CRA) methodology. Populationattributable fractions (PAFs) calculated from modelled prevalence estimates and relative risks based on the global review were applied to the burden of disease estimates from the revised South African National Burden of Disease study for 2000. The alcohol-attributable fractions for injuries were directly determined from blood alcohol concentrations (BAC > 0.05 g/ 100 ml) at the time of injury. Monte Carlo simulationmodelling techniques were used to quantify uncertainty in the estimates. Setting. South Africa. Subjects. Adults ≥ 15 years. Outcome measures. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, stroke, hypertensive disease, diabetes, certain cancers, liver cirrhosis, epilepsy, alcohol use disorder, depression and intentional and unintentional injuries as well as burden from fetal alcohol syndrome (FAS) and low birth weight. Results. Alcohol harm accounted for an estimated 7.1% (95% uncertainty interval 6.6 - 7.5%) of all deaths and 7.0% (95% uncertainty interval 6.6 - 7.4%) of total DALYs in 2000. Injuries and cardiovascular incidents ranked first and second in terms of attributable deaths. Top rankings for overall attributable burden were interpersonal violence (39.0%), neuropsychiatric conditions (18.4%) and road traffic injuries (14.3%). Interpersonal violence accounted for 42.8% of the injury DALYs attributed to alcohol in males and 25.9% in females. In terms of alcohol-attributable disability, alcohol use disorders ranked first (44.6%), interpersonal violence second (23.2%), and FAS third (18.1%). Conclusions. Particular attention needs to be given to preventing and reducing the burden of alcohol-related homicide and violence, alcohol-related road traffic accidents, alcohol use disorders, and FAS. Multilevel interventions are required to target high-risk drinkers, in addition to creating awareness in the general population of the problems associated with alcohol abuse.