LIVING WITH CHRONIC ILLNESS

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

A chronic illness is defined as a condition that lasts for a year or more, requires ongoing medical attention, and often impacts on your ability to perform daily activities.

Chronic illness is a reality for millions of South African women — from diabetes, hypertension, and HIV to asthma, arthritis, and depression. These long-term health conditions often require daily management, medication, and lifestyle adjustments.

While chronic illness may impact how you live, with the right support, knowledge, and tools, it is possible to live a full, healthy, and meaningful life. By adopting preventive measures, women can significantly reduce their risk of developing chronic illnesses and improve their overall quality of life.

CHRONIC ILLNESS IN SOUTH AFRICA

Many of these illnesses are linked to lifestyle, stress, and access to healthcare — and they often occur together (known as comorbidity), which makes management more complex.

Common chronic conditions affecting South African women include:

HIV/AIDS

South Africa has the largest HIV epidemic globally, with women accounting for a majority of those living with HIV. In 2022, HIV prevalence was estimated to be nearly twice as high among women (20%) compared to men (12%) in the population aged 15 years and older. Young women (15-24 years) are disproportionately affected, with rates ranging from 15% to 25%.
Diabetes

Diabetes is the leading cause of death in South African women. A large proportion of these women are unaware of their condition and so do not get the treatment they need. Obesity and overweight are significant risk factors for diabetes. Studies show that more than 60% of women in South Africa are overweight or obese, and this rate number is increasing.
Hypertension (high blood pressure)

According to the South African Medical Research Council, 48% of South African women are estimated to have hypertension, compared to 34% of men. A concerning number of people with hypertension are unaware of their condition, and even fewer have it under control. Hypertension is closely linked to cardiovascular diseases like strokes and heart attacks, which account for more deaths than all cancers combined.
Asthma

While asthma is more common in boys during childhood, adult women are more likely (10.8%) to have asthma than adult men (6.5%). Asthma cannot be cured, but it can be controlled. Women also experience higher asthma mortality rates than men, with South Africa having one of the highest asthma mortality rates in the world. Unfortunately it is under-diagnosed and under-treated.
Arthritis

Women are more likely than men to develop arthritis, particularly osteoarthritis and rheumatoid arthritis. Osteoarthritis, often called “wear-and-tear” arthritis, is more common in older women, especially affecting the knees. Rheumatoid arthritis, an autoimmune disease, also affects women more frequently, with a 2-3 times higher likelihood compared to men. Arthritis is estimated to affect 30% of the general South African population and about 83% of those aged 65 and older.
Depression and anxiety

Poverty, violence (including intimate partner violence), and social inequalities are significant risk factors for depression and anxiety in South African women. It is thought that depression and anxiety account for 21% of the non-fatal diseases experienced by South African women.
Tuberculosis (TB)

TB is a leading cause of death in South Africa, and also a major contributor to maternal mortality, especially in the context of HIV co-infection. South Africa is among the countries with the highest burden of TB globally; pregnant women with latent TB are more likely to develop active TB, and women in the early postpartum period are at higher risk than non-pregnant women.
Heart disease

South African women have alarming rates of cardiovascular disease (CVD) and related conditions like rheumatic heart disease. Factors such as lifestyle changes, including lack of exercise and poor diet, combined with existing health issues like hypertension and diabetes, contribute to this burden. The proportion of CVD deaths in South African women aged 35–59 years is one and a half times more likely than that of women in the United States.

RISK FACTORS FOR CHRONIC ILLNESS

Several factors increase the risk of chronic diseases in women, some lifestyle related and some out of our control like biological factors and socio-economic realities. Specific conditions like autoimmune diseases, depression, and certain reproductive health issues also contribute to a higher disease burden in women.

Lifestyle choices that increase your risk:
Unhealthy diet: Diets low in fruits and vegetables, and high in saturated fats, sugars, and salt, increase the risk of cardiovascular disease, diabetes, and some cancers.

Physical inactivity: Sedentary lifestyles contribute to weight gain, obesity, and increased risk of chronic diseases like type 2 diabetes and heart disease.

Tobacco use: Smoking is a major risk factor for various cancers, cardiovascular disease, and respiratory illnesses.

Excessive alcohol consumption: Heavy and binge drinking can lead to liver disease, certain cancers, and other health problems.
Biological and reproductive factors:
Reproductive health: Conditions like endometriosis, fibroids, and polycystic ovary syndrome can cause chronic pain and other health issues.

Pregnancy complications: Women who experience gestational diabetes or preeclampsia during pregnancy are at higher risk for developing chronic diseases later in life.

Menopause: The hormonal changes associated with menopause can increase the risk of osteoporosis and cardiovascular disease.
Other important risk factors:
Age: The risk of many chronic diseases increases with age.

Social determinants: Factors like socioeconomic status, education level, and access to healthcare can influence a woman’s risk of chronic disease.

Mental health: Depression and anxiety, which are more prevalent in women, are linked to an increased risk of chronic diseases.

Early life experiences: Adverse childhood experiences and trauma can also increase the risk of chronic conditions later in life.

Multimorbidity: Women are more likely to experience multiple chronic conditions, which can complicate treatment and management.

PREVENTING CHRONIC ILLNESS

By understanding your risk factors, you can take proactive steps to improve your health and reduce your risk of chronic diseases. This involves a combination of lifestyle choices and regular health screenings:

Lifestyle factors:
Healthy diet: A diet rich in fruits, vegetables, whole grains, and lean protein helps maintain a healthy weight and provides essential nutrients, reducing the risk of chronic diseases.

Regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise per week. This can include activities like brisk walking, swimming, or dancing. You don’t have to do it all at once – 30 minutes of exercise, 5 days a week, will give you 150 minutes.

Weight management: Maintaining a healthy weight is crucial for overall health and can significantly reduce the risk of chronic conditions like type 2 diabetes and heart disease.

Stress management: Chronic stress can negatively impact health. Practices like mindfulness, meditation, and spending time in nature can help manage stress levels.

Sufficient sleep: Aim for 7-9 hours of quality sleep per night. Adequate sleep is essential for physical and mental restoration and can reduce the risk of various chronic diseases.

Avoiding harmful substances: Smoking and excessive alcohol consumption are major risk factors for many chronic diseases. Quitting smoking and limiting alcohol intake are vital steps for prevention.
Preventative healthcare:
Regular check-ups: Routine visits to healthcare providers for check-ups and screenings are essential for early detection and management of chronic conditions.

Cancer Screenings: Follow recommended guidelines for cancer screenings like mammograms (breast cancer), Pap tests (cervical cancer), and colonoscopies (colorectal cancer).

Vaccinations: Stay up-to-date on recommended vaccinations, including those for influenza and other infectious diseases.

Oral Health: Maintain good oral hygiene by brushing and flossing regularly and visiting the dentist for check-ups.
Additional considerations:
Early life experiences: Be aware of the potential impact of adverse childhood experiences and trauma on long-term health.

Mental health: Prioritise mental health and seek support when needed. Mental and physical health are closely linked.

LIVING WELL WITH CHRONIC ILLNESS

Being diagnosed with a chronic illness isn’t the end of the road. It’s a new path — one that still holds health, love, joy, and hope. You are allowed to rest. You are allowed to ask for help. And you are more powerful than your condition.

1. Understand your condition
2. Stick to your treatment
3. Choose healthy habits
Your everyday choices play a huge role in managing chronic illness:

Eat well: Focus on local, nutritious options — morogo, beans, brown rice, vegetables, and lean meats.

Stay active: Walking, dancing, or stretching for 20–30 minutes a day helps with circulation, energy, and mood.

Limit salt, sugar, and processed foods

Quit smoking and reduce alcohol
4. Look after your mental health
Living with chronic illness can take a toll emotionally. It’s normal to feel frustrated, tired, or discouraged. You are not weak for needing help. Reach out to:

SADAG Mental Health Helpline – 0800 456 789

Lifeline South Africa – 0861 322 322

Local clinic social workers or counsellors

Talking, resting, journaling, or joining a support group can make a big difference
5. Build a support system
You don’t have to face chronic illness alone. Let trusted family, friends, neighbours, or support groups know what you’re going through.

Find strength in:

Bonitas Managed Care Programmes

Community clinics and churches

WhatsApp groups for chronic illness support

Non-profits offering food parcels or transport help for appointments

LIVING WITH CHRONIC ILLNESS

LIVING WITH CHRONIC ILLNESS

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

CHRONIC ILLNESS IN SOUTH AFRICA

RISK FACTORS FOR CHRONIC ILLNESS

PREVENTING CHRONIC ILLNESS

LIVING WELL WITH CHRONIC ILLNESS

FURTHER READING