Women are living longer, but chronic disease taking deadly toll

The latest mortality data from Statistics South Africa tells two distinct stories about mortality in South Africa. Women are living longer than men but are increasingly dying from chronic non-communicable diseases. Men, meanwhile, continue to die younger and are far more likely to succumb to infectious diseases, violence, accidents and other non-natural causes.

In 2024, men accounted for 53.4% of all registered deaths, while women accounted for 46.6%. The gap between the sexes was one of the widest recorded in recent years. Women, however, continued to outlive men. The median age at death for women was 65 years, compared with 55 years for men. Women also outnumbered men among deaths recorded from age 70 and older, highlighting their greater longevity.

Chronic diseases dominate women’s mortality

Yet living longer does not necessarily mean living healthier.

For women, non-communicable diseases have become the dominant threat. Diabetes mellitus remained the leading cause of death among women in 2024, responsible for 7.9% of female deaths. Hypertensive diseases followed at 7.1%, while cerebrovascular diseases, including strokes, accounted for 6.4%. Together, these three conditions were responsible for more than one in every five female deaths.

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The report shows that six of the ten leading causes of death among women were non-communicable diseases. Diabetes has remained the leading cause of death for women for three consecutive years, underlining the growing burden of chronic illness in the country.

Infectious diseases are declining among women

There is some evidence of progress against infectious diseases among women. HIV-related deaths accounted for 4.0% of female deaths in 2024, while tuberculosis was responsible for 2.9%. Both have declined from earlier years, reflecting gains in treatment access and disease management.

At the same time, cancers affecting women are becoming increasingly important. Malignant neoplasms of female genital organs ranked eighth among the leading causes of death for women, responsible for 2.9% of female deaths. The proportion has risen steadily from 2.4% in 2022 to 2.9% in 2024.

Men face a different mortality crisis

The picture for men is markedly different.

While non-communicable diseases remain significant, infectious diseases continue to exact a heavy toll. Tuberculosis was the leading cause of death among men, accounting for 4.8% of male deaths. Cerebrovascular diseases and diabetes mellitus followed jointly at 4.5%, while HIV-related illnesses accounted for 3.7%. Influenza and pneumonia contributed 3.2%, and chronic lower respiratory diseases 3.0%.

Unlike women, men are also disproportionately affected by non-natural causes of death. Nearly one in five male deaths (19.6%) resulted from injuries, violence, transport accidents or other external causes, compared with just 5.9% among women.

Young men most at risk

Young men remain especially vulnerable. Among males aged 15 to 29 years, almost 60% of all deaths were due to non-natural causes. Assault accounted for 18.4% of male non-natural deaths in this age group, while transport accidents and accidental injuries continued to claim thousands of lives.

The report’s age profile highlights the contrast between male and female mortality. Women experienced the highest concentration of deaths between ages 70 and 84, peaking in the 70-74 age group. Men, by contrast, recorded their highest proportion of deaths in the 60-64 age group, reflecting a greater burden of premature mortality.

Double burden for South Africa

Overall, the report shows South Africa undergoing a profound health transition. Communicable diseases such as HIV and tuberculosis remain important, particularly among men, but chronic diseases now dominate mortality patterns, especially among women.

Diabetes, hypertension and stroke are increasingly becoming the defining health challenges of older age, while violence, road accidents and other injuries continue to cut short the lives of many young men. Non-communicable diseases accounted for the majority of female deaths, while men carried a disproportionate burden of both infectious diseases and external causes of death. [Mortality | PDF]

The bottom line

What emerges is not one mortality story, but two.

Women are surviving longer but are increasingly dying from chronic illnesses that often require lifelong management. Men, on the other hand, are dying earlier, with tuberculosis, HIV, violence and accidents continuing to exact a heavy toll.

The findings suggest that South Africa’s health system faces a dual challenge: preventing and managing chronic diseases among ageing women, while reducing preventable deaths from infectious diseases, violence and injuries among men. If these trends continue, the country’s future health gains will depend not only on treating disease, but on addressing the social and behavioural factors driving premature mortality among both sexes.

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