This study examines the relationships between apartheid and the distress experienced by adult urban-dwelling Africans in South Africa. The effects of apartheid are conceptualised and measured as social and economic disadvantage, and this operational definition is justified by a review of the socioeconomic and health aspects of apartheid policies and practices. Distress is conceptualised and measured as (1) exposure to stressors and (2) experiences of ill health. Data was collected from 147 subjects. Analyses indicate that the effects of apartheid (represented by socio-economic disadvantage) are significantly related to the experience of distress (represented by stress and illness) for black South Africans. Multivariate analyses suggest also that the relationships between disadvantage and distress are more complex than a simple and direct relationship between two variables.