Which province is best to live in?

Gauteng, the Western Cape and KwaZulu-Natal boast the best living conditions in the country, but also suffer the highest crime rates and in-migration from poorer provinces, reports the South African Institute of Race Relations.

The Institute's summary report, tellingly titled Each province is another country, compares how the nine provinces shape up in terms of economy, living conditions, health and crime.

The results show considerable disparity between the provinces and some worrying national trends; the standout points are summarised here:

Richest provinces are most crowded

As measured by percentage contribution to the country's gross domestic product, Gauteng (34%), KwaZulu-Natal (16%) and the Western Cape (14%) are economically way ahead of the other provinces, each of which contribute under 7.5% or less.

Living conditions in the three most urbanised provinces are overall the best in the country.

Not surprisingly, the provinces with the strongest economies have potential employment and better living standards as potent pull factors, and see the highest net in-migration rates. This swells their already high population numbers and decimates those of the poorer provinces.

Gauteng houses the biggest proportion of the country’s population, 22%, on only 1% of the land area, making it by far the most densely populated province at 684 people per square kilometre.

KwaZulu-Natal follows with 21% of the population on 8% of the land area: 114 people per square km.

By comparison the Northern Cape has the smallest population percentage (2%) on the  biggest land area (28%). Population density: three people per square kilometre.

Health disparities

Inhabitants of the wealthier provinces enjoy better health, with the exception of KZN which suffers high adult mortality rates.

HIV/Aids and related illnesses, particularly TB, continues to affect all provinces, but KZN is hardest hit with the highest number of AIDS deaths and percentage of HIV-positive people (15%) in the country. KZN also has the highest rate of TB deaths and reported TB cases.

The Western Cape has the lowest HIV prevalence rate (5%).

The Eastern Cape’s health provision crisis is reflected in the high number of vacant posts for nurses (25 954), and poor under-five mortality rate (68 children under age 5 die per 1 000 babies born alive). By comparison, the Western Cape has 465 nurse vacancies, and the lowest under-five mortality rate (27 per 100 000 children).

Under-five mortality rate is often used as an indicator of general health standards. Nationally, SA's under-five mortality rate is 50 deaths per 100 000 children. In the developed world, under-five mortality rates average about 5 deaths per 100 000. 

Life expectancy (which factors in infant mortality rates) is another key indicator of health and quality of life. Provincially, SA's life expectancy ranges from 59.9 years for men and 65.8 years for women in the Western Cape, to 44.6 for men and 47.9 for women in the Free State.

SA's average life expectancy is around 54 years, which is well below global average. It has also declined since last century, which goes against the global trend of gradually increasing life expectancy.

According to a World Health Organisation report in May this year, the average life expectancy globally is mid-60s, with most expectancies in the developed world well into the 70s and 80s.

Fertility rate

Fertility rate is dropping across the country, with the lowest fertility rates in the most urbanised provinces, notably Gauteng and the Western Cape.

Urbanisation is associated with higher costs of raising a child, improved education and contraception, and more women entering the work force – all factors that contribute to women having fewer children, and delaying having their first child.

Highly urbanised Gauteng consequently has the lowest fertility rate (2.10 births per woman). Limpopo's fertility rate is highest at 2.85 births per woman.


The down side of living in one of the wealthier provinces, states the Institute's report, is that crime statistics are higher.

There appears to be more drug-related crime in coastal provinces than inland regions. This is especially true for the Western Cape, with 1 351 drug-related incidents per 100 000 people this year, an increase of 322% since 1994. KwaZulu-Natal had the second highest rate (305 incidents) and the second highest increase (189%).

Gauteng's crime rate remains among the highest in the country, but this has seen the greatest decrease since 1994. The province has  the highest number of registered security companies.

- Olivia Rose-Innes, Health24, December 2011

Read more:
How many kids are too many?

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