According to Statistics South Africa's (Stats SA) latest report, a total of 474,366 deaths that occurred in 2024 were registered and processed, down from 483,298 in 2023. This decline continued a trend observed after 2021 following a decrease in Covid-19-related deaths. The report examined deaths that occurred during the 2024 calendar year and used civil registration data from the department of home affairs.
Diabetes mellitus remained the country's leading underlying cause of death for the third consecutive year in 2024, accounting for 6.1% of deaths. Hypertensive diseases were second at 5.5%. Nine of the 10 leading causes of death in 2024 were the same over the three-year period, though their rankings and proportions differed. Covid-19, which became the leading underlying cause of death in 2020, has subsequently dropped out of the top 10.
There were significant differences between provinces, with diabetes mellitus the leading underlying cause of death in the Western Cape (7.3%), KwaZulu-Natal (7.0%), Limpopo (6.9%), Eastern Cape (5.8%) and Gauteng (4.6%). Hypertensive diseases, meanwhile, were the leading underlying cause in North West at 8.5%, Northern Cape at 8%, Free State at 7.1% and Mpumalanga at 6.4%.
Six causes of death appeared in all nine provinces: diabetes mellitus, cerebrovascular diseases, hypertensive diseases, HIV disease, tuberculosis and other forms of heart disease. Cerebrovascular diseases were particularly prominent in the coastal provinces, ranking second in the Western Cape and KwaZulu-Natal and third in the Eastern Cape, Free State, North West, Gauteng and Limpopo.
While nine of the 10 leading underlying causes were common to both sexes, there were notable differences in their rankings. Tuberculosis was the leading underlying cause of death among men in 2024, accounting for 4.8% of deaths. For women, diabetes was the leading underlying cause, accounting for 7.9% of deaths, followed by hypertensive diseases at 7.1% and cerebrovascular diseases at 6.4%.
The causes of death varied sharply according to age. Influenza and pneumonia were the only underlying cause appearing among the leading causes across all broad age groups. Among children aged one to 14, influenza and pneumonia were the leading cause, accounting for 7.9% of deaths. For infants, respiratory and cardiovascular disorders specific to the perinatal period were the leading underlying cause, accounting for 15.5% of deaths.
Overall, men accounted for 53.4% of deaths registered in 2024 compared with 46.6% for women. People aged 65 to 69 accounted for the largest proportion of registered deaths in 2024 at 9.1%. Stats SA noted that the figures are based on death notification forms and that the underlying cause refers to the disease or injury that initiated the sequence of events that led directly to death.
Key points
- Tuberculosis was the leading underlying cause of death among men in 2024.
- Diabetes mellitus was the leading underlying cause of death among women in 2024.
- Chronic conditions dominated deaths among women in 2024.
