South Africa’s ageing population is increasing steadily, bringing both opportunities and challenges for ensuring that people age well. According to the Marginalised Groups Series VIII – Healthy Ageing in South Africa, 2024, released by Statistics South Africa, the number of persons aged 60 years or older in South Africa increased from 3,6 million (7,7% of the population) in 2002 to 6,6 million (10,5%) in 2025—an increase of 3,0 million over 23 years. This growth is closely linked to declining fertility rates, longer life expectancy and improvements in overall living conditions. Ageing indexes have increased across all population groups, with the white older population showing the highest rise—from 87 in 2002 to 227 in 2025—reflecting significant shifts in population structure.

Older South Africans are predominantly female. In 2002, for every 100 older women, there were only 67 older men. By 2025, this fell to 65 older men for every 100 older women, meaning older women still significantly outnumber older men. This imbalance has social implications: older women are more likely to be widowed, have fewer financial resources, and face more health-related challenges, while older men are more likely to remain married.

These demographic changes shape the broader concept of healthy ageing, defined as developing and maintaining the functional abilities that enable well‑being in older age. Data from the report shows how conditions for older people have changed over time.

Household and Living Arrangements

The proportion of households headed by older persons increased from 19,3% in 2002 to 20,6% in 2024, highlighting their central role in families and communities. Household patterns differ markedly from the national picture. When examining the living arrangements of households in general and those headed by older persons in 2003 and 2024, extended households—homes that include relatives beyond the immediate family, such as adult children, grandchildren or other family members—were more common among households headed by older persons (over 50%) than among South African households overall (31,7%). Gender differences were notable: older females were more likely to live in extended households or to live alone. Older males, on the other hand, were more likely to live in both extended households and nuclear households, which consist only of a couple and their children, and were more likely to live with a spouse. Higher child-to-older-person ratios in older female-headed households point to a greater caregiving burden on older women.

Health and Access to Services

According to the 2025 data, women in South Africa live longer than men, with life expectancy at 69,6 years for women compared to 64,0 years for men. Patterns in access to healthcare have also shifted gradually. Medical aid coverage among older persons rose slightly—from 19,1% in 2002 to 21,9% in 2024—and consistently exceeded coverage for the overall population, which declined from 15,9% to 15,5% over the same period. However, the gains were not shared equally across all groups, with disparities still evident by sex, population group and province.

Chronic conditions shaped much of older persons’ health needs. High blood pressure, diabetes and arthritis were the most frequently reported illnesses, with hypertension being a leading cause of death. Disability levels eased marginally, declining from 27,5% in 2011 to 25,0% in 2022, although the highest prevalence was recorded among older black Africans at 27,0%.

Public health facilities continued to anchor healthcare use. In 2002, 60,2% of older persons relied on public hospitals and clinics, rising to 68,5% in 2024.

Despite the overall national increase, provincial trends varied. Public facility use increased in most provinces, while the Western Cape and Northern Cape recorded decreases—and also exhibited the highest use of private facilities. Access to primary care was generally viewed positively: in 2022/23, 88,7% of older persons reported that clinics were easy to reach and more affordable than hospitals. However, government hospitals received higher satisfaction ratings than public clinics.

Income and Employment

Financially, older (60 years+) households relied more heavily on social support. Grants were the primary income source for older‑person‑headed households in 2024, supporting 60,1% of them, followed by salaries, wages or commission at 21,0%. The past two decades brought gradual improvements, with poverty rates among older persons falling across all three national poverty lines between 2006 and 2023.

However, Labour Market Participation among older persons remained low across all provinces. Although older men were more likely to be employed, their employment rates fell, whereas employment among older women rose. Work opportunities differed by gender: older women were most commonly employed in domestic work, whereas older men were more concentrated in skilled occupations.

Living Conditions and Access to Basic Services

Living conditions saw significant improvements over time. Formal housing became nearly universal among older persons, increasing from 75,8% in 2002 to 91,3% in 2024. Many older persons also lived in homes that were fully paid off—68,1% in 2002 and 64,3% in 2024—while residence in informal dwellings declined across all provinces.

Access to basic services advanced steadily, especially in non‑urban areas. Electricity and sanitation access saw notable gains, and the digital landscape changed dramatically: internet access surged from 22,6% in 2009 to 86,6% in 2024. Public transport satisfaction was generally positive, though long waiting times and negative interactions with drivers or staff remained common concerns.

Despite these advances, challenges remain—including uneven healthcare access, limited medical aid coverage, low employment participation, economic vulnerability and declining perceptions of safety—which continue to shape the experience of ageing in South Africa.

For more information, download the full report here.