South Africa is a developing country that also has developed aspects and as a result, has to cope with issues related to both worlds. There has been a definite change in the global patterns of diseases from a situation dominated by infectious diseases to a predominance of non-communicable diseases where the risk factors are largely associated with lifestyle. Results from a follow-up study were used to investigate a transition in health status of the study sample. Questionnaires were used in this historical cohort study, which reviews the health status and lifestyle aspects of young adults who participated as children in the Vaal Triangle Air Pollution Health Study (VAPS) during 1990. In general, the study sample had a higher prevalence of chronic diseases compared to the general South African population. Findings indicate that the transition in health status recorded elsewhere in the world can be demonstrated in this South African group.