撒哈拉以南非洲地区的死亡率数据和比较风险评估有限。迫切需要开展高质量的人口健康调查，完善国家健康监测体系。我们的目的是对来自国际前瞻性城乡流行病学研究南非地点的参与者的死亡率状况和死因数据进行比较风险评估并报告。1 包括 921 名黑人参与者，中位观察时间为 13年，共计 21 525 人年。我们进行了比较风险评估，考虑了四个健康状况领域：地点（农村与城市）、社会经济地位（SES）（教育和就业）、生活方式因素（体力活动、吸烟和饮酒）和流行疾病（人类免疫缺陷）病毒（HIV）、2 型糖尿病和高血压）。接下来，计算人口归因分数 (PAF)，以确定可归因于可修改决定因素的死亡风险。发生了 577 例全因死亡。传染病（占所有死亡的28.1%）是最常见的死因，其次是心血管疾病（CVD）（22.4%）、呼吸系统疾病（11.6%）和癌症（11.1%）。造成全因死亡率的三个主要因素是艾滋病毒感染、高社会经济地位和体重不足。 HIV 感染和体重不足是传染病死亡率和高血压、城市环境以及缺乏身体活动导致 CVD 死亡率的主要原因。艾滋病毒的 PAF 最高，其次是缺乏身体活动、酗酒和吸烟以及高血压（CVD 死亡率）。非洲人口承受着四倍的疾病负担。城市地区、高社会经济地位、流行疾病（艾滋病毒和高血压）和生活方式因素（缺乏身体活动、吸烟和饮酒）都不同程度地导致了全因和特定原因死亡率。我们的数据证实了解决艾滋病毒和高血压问题对公共卫生的重要性，但也强调了缺乏身体活动、吸烟和饮酒作为公共卫生战略焦点的重要性，以产生最有效的死亡率降低结果。© 2024。作者）。

Mortality data and comparative risk assessments from sub-Saharan Africa are limited. There is an urgent need for high quality population health surveys to be conducted, to improve the national health surveillance system. Our aim was to perform a comparative risk assesment and report on the mortality status and cause of death data of participants from a South African site of the international Prospective Urban Rural Epidemiology study.1 921 Black participants were included, with a median observational time of 13 years resulting in 21 525 person-years. We performed a comparative risk assessment considering four health status domains: locality (rural vs. urban), socio-economic status (SES) (education and employment), lifestyle factors (physical activity, smoking and alcohol consumption) and prevalent diseases (human immunodeficiency virus (HIV), type 2 diabetes mellitus and hypertension). Next, population-attributable fractions (PAFs) were calculated to determine the mortality risk attributable to modifiable determinants.577 all-cause deaths occurred. Infectious diseases (28.1% of all deaths) were the most frequent cause of death, followed by cardiovascular disease (CVD) (22.4%), respiratory diseases (11.6%) and cancer (11.1%). The three main contributors to all-cause mortality were HIV infection, high SES and being underweight. HIV infection and underweight were the main contributors to infectious disease mortality and hypertension, the urban environment, and physical inactivity to CVD mortality. HIV had the highest PAF, followed by physical inactivity, alcohol and tobacco use and hypertension (for CVD mortality).This African population suffers from a quadruple burden of disease. Urban locality, high SES, prevalent disease (HIV and hypertension) and lifestyle factors (physical inactivity, tobacco and alcohol use) all contributed in varying degrees to all-cause and cause-specific mortalities. Our data confirm the public health importance of addressing HIV and hypertension, but also highlights the importance of physical inactivity, tobacco use and alcohol consumption as focal points for public health strategies to produce the most efficient mortality reduction outcomes.© 2024. The Author(s).