How much difference can good health habits, early screening, and access to quality healthcare really make?
According to Discovery Health’s HealthTrend26 report, the gap between a healthy life and a complex chronic disease pathway can amount to as much as 11.4 years of life expectancy.
The finding forms part of a new analysis based on more than 60 million life years of clinical, pathology, lifestyle, and behavioural data drawn from Discovery Health’s integrated data ecosystem. The report covers Discovery Health Medical Scheme’s 2.7 million members, representing almost 60% of South Africa’s open medical scheme market, and analyses healthcare trends across 64 million claims worth R90 billion in 2025 alone.
At the launch of the report, Discovery Health chief executive Dr Ronald Whelan said the findings show healthcare is changing in ways that are not always visible in headlines.
Members are living longer and surviving conditions that would previously have been life-limiting. But they are also increasingly living with multiple chronic conditions that require ongoing management. As a result, healthcare is shifting away from episodic treatment towards continuous, integrated care focused on prevention, early intervention, and personalised health pathways.
The report identifies six major trends shaping healthcare demand.
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People are living longer – and needing healthcare for longer
The first trend is straightforward: people are living longer.
Between 2014 and 2024, mortality rates among Discovery Health Medical Scheme (DHMS) members declined across every age group. The biggest improvement was among young adults aged 24 to 39, where deaths per 100 000 lives fell by 16.3%. Mortality among members aged 75 and older declined by 7.8%, while mortality among adults aged 40 to 74 declined by 2.5%.
Longer lives, however, also mean longer periods of healthcare utilisation.
Inflation-adjusted healthcare claims per member rose by 28% among elderly members, 24% among adults aged 40 to 74, 25% among young adults, and 19% among children.
The report argues that healthcare is increasingly becoming a long-term relationship rather than a series of isolated interventions.
It also highlights the role medical schemes play when serious illness strikes.
In 2025, the top 1% of members, representing roughly 29 000 lives, accounted for R24.7bn in healthcare spending and 33% of all claim costs. The top 5% of members accounted for 63% of total claims expenditure.
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Chronic conditions are becoming more complicated
The second trend is not simply that chronic diseases are becoming more common, but that they are increasingly occurring together.
DHMS currently supports more than 450 000 members through integrated programmes covering diabetes, cardiovascular disease, oncology, and mental health.
More than half of members with chronic illness now live with multiple chronic conditions.
The overlap is particularly striking among diabetes patients. According to the report, 92% of members with diabetes have at least one additional chronic condition. The figure is 67% among oncology patients and 48% among members with cardiovascular disease.
These overlapping conditions carry significant cost implications.
Members with three or more chronic conditions account for just 10% of membership but drive 43% of healthcare expenditure.
The report argues that traditional single-condition treatment models are increasingly inadequate and that co-ordinated, personalised care is becoming essential.
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Mental health is moving to the centre of healthcare
Mental health emerged as one of the fastest-growing areas of healthcare demand.
The prevalence of mental health conditions among members aged 18 to 30 increased by 80% between 2015 and 2025, rising from approximately one in 12 young adults to one in seven.
Importantly, the increase does not appear to reflect worsening illness severity.
Despite the rise in prevalence, hospital admission rates for mental-health conditions declined by 11% over the same period. Discovery attributes this to earlier diagnosis, improved screening, and greater willingness to seek treatment.
Depression remains the dominant diagnosis, accounting for 63% of mental health claimants. Women show a 1.5-times higher prevalence of mental health conditions than men, while prevalence among single members is 1.3 times higher than among family members.
The report also highlights the strong link between mental and physical health.
Members with chronic conditions and a mental health diagnosis incur healthcare costs 3.8 times higher than healthy members and experience hospitalisation rates 3.5 times higher.
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Cancer is increasingly becoming a long-term condition
Perhaps one of the most striking findings in the report is how dramatically cancer outcomes have improved.
Over the past 15 years, life expectancy among oncology-registered members increased by 7.1 years, while cancer mortality declined by 48%.
DHMS funded R4.6bn in oncology-related claims during 2025 and covered 93% of oncology treatment costs. More than 108 000 members are currently enrolled in its oncology programme.
The report attributes the improvement largely to earlier diagnosis and better treatment options.
Regular screening increases the likelihood of early-stage diagnosis by 19% and is associated with a 67% reduction in relative mortality risk.
The impact of early detection is particularly evident in breast cancer.
Members diagnosed at an early stage have a 96% five-year survival rate, compared with 61% for those diagnosed after the disease has metastasised.
Treatment options have also changed dramatically.
The number of members accessing biological and immunological cancer therapies has tripled over the past decade, contributing to improved outcomes and longer survival.
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Cardiovascular health may be the biggest opportunity
Cardiovascular disease remains one of the largest drivers of healthcare costs.
The prevalence of cardiovascular disease among Discovery members increased from 13.3% in 2015 to 20.8% in 2025. Today, approximately one in five members lives with cardiovascular disease, accounting for 53% of total healthcare spending.
The report identifies cardiovascular health as one of the most measurable and modifiable areas of healthcare.
Several relatively simple interventions are associated with substantial reductions in cardiovascular risk:
- Smoking cessation reduces major cardiovascular event risk by 36%.
- Physical activity of at least 60 minutes per week reduces risk by 27%.
- LDL cholesterol control reduces risk by 26%.
- Blood-pressure control reduces risk by 22%.
- Weight management reduces risk by 15%.
One of the report’s more eye-catching findings is that members with optimal cardiovascular health can have a biological age up to six years younger than their chronological age.
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The prevention dividend is real
The final trend brings all the others together.
Discovery refers to it as the “prevention dividend” – the idea that earlier intervention generates benefits that compound over time.
The report estimates that the difference in life expectancy between a healthy pathway and a complex chronic pathway can reach 11.4 years.
To support earlier intervention, Discovery has rolled out Personal Health Pathways, a personalised health management platform.
More than 650 000 members have activated the programme, collectively completing more than 1.2 million clinical actions and 7 million exercise goals.
The programme is already identifying opportunities for earlier intervention.
According to the report, 23% of health checks identify abnormal results, while 1.3% of first-time cancer screenings detect cancer. These are opportunities for treatment before conditions become more severe.
The report’s central message is ultimately a simple one.
Discovery’s data suggests that the gap between a healthy life and a complex chronic pathway can amount to 11.4 years of life expectancy. Those years are not determined by luck alone. Earlier screening, healthier habits, better disease management, and timely intervention can materially change the trajectory.
