In recent years South Africa has had to deal with the problem of multiple disease burdens. Non-communicable diseases (NCDs) are rising and emerging as the leading causes of death in the country. Existing empirical evidence suggests that different social conditions influence health outcomes in a population. In the present study, a social disadvantage approach was employed to examine demographic and socioeconomic gradients in self-reported diagnosed chronic conditions. Analyses were based on a sample of 45,913 adults aged 18 years and older drawn from the 2018 South African General Household Survey data, using multivariate regression techniques to assess the distribution and predictors of chronic ill- health in South Africa. The reported burden of chronic ill-health was 17.3\%. Factors independently associated with the risk of NCDs included increasing age, population group, lower wealth index, lower education, urban residence and province of residence. The findings confirmed the existence of socioeconomic gradients as well as a gender gap in chronic ill-health, to the detriment of vulnerable sub-groups. Policy implications are discussed.