Health Inequalities Annual Report 2025

Date published: 10 September 2025

This publication presents a comprehensive analysis of health inequality gaps between the most and least deprived areas of Northern Ireland, and sub-regional gaps within Health & Social Care (HSC) Trust and Local Government District (LGD) areas across a range of health indicators. 

Key Findings – Regional 

• Deprivation gaps for male and female life expectancies at birth saw no change since 2017-19 with the most-least deprivation gaps stood at 7.3 years for males and 5.2 years for females in 2021-23. Following a downward trend in male and female life expectancies between 2017-19 and 2020- 22 in Northern Ireland and the most and least deprived areas, estimates have largely returned to pre-pandemic levels.
• Inequality gaps narrowed for both male and female disability-free life expectancies (DFLE) following improvements in the most deprived areas. While the inequality gap for female healthy life expectancy (HLE) narrowed since 2017-19, there was no change in the gap for males, with the most-least deprived gaps in HLE stood at 13.6 years for males and 14.0 years for females in 2021-23.
• Large inequality gaps continue to highlight markedly higher rates of premature mortality in the most deprived areas, with no changes in any of the inequality gaps analysed over the period. There were improvements observed across all areas for treatable mortality. The opposite was true for preventable mortality worsened over the period regionally, and in the most and least deprived areas.
• The rate of respiratory deaths in the most deprived areas among persons aged under 75 years was almost three and a half times the rate in the least deprived areas.
• Large inequality gaps continue to exist for mental health indicators. Prescription rates for mood and anxiety disorders increased regionally and for the most & least deprived areas between 2019 and 2023, with the rate in the most deprived areas two-thirds higher than in the least deprived areas.
• In 2021-23 the suicide mortality rate in the most deprived areas was almost three times the rate observed in the least deprived areas, with the gap widening over the analysed period.
• Alcohol and drug related indicators continue to show some of the largest health inequalities monitored in Northern Ireland. The deprivation gap for drug misuse deaths widened over the analysed period and showed the largest inequality gap, with mortality in the most deprived areas almost six times that of the least deprived.
• While improvements in smoking in pregnancy and the under 20 teenage birth rate were seen within all areas during the analysed period, the most-least deprived inequality gaps are still among the highest across all HSCIMS indicators. The rate of smoking in pregnancy in the most deprived areas was over six times the rate in the least deprived areas in 2023, representing a widening of the inequality gap.
• In 2023/24 the percentage of year 8 pupils in the most deprived areas affected by obesity was more than double that in the least deprived areas.

Key Findings – Sub-Regional

• Male and female life expectancies were lowest in the Belfast LGD (76.5 years and 80.6 years respectively). Male life expectancy was highest in Lisburn & Castlereagh LGD (80.9 years), and female life expectancy was highest in Ards & North Down and Mid Ulster LGDs (83.4 years).
• Similar to the regional picture, deprivation related inequality was most prominent in indicators relating to alcohol, drugs, self-harm, smoking during pregnancy and teenage births, which were among the five largest inequality gaps for the majority of Trusts and LGDs.
• Drug misuse mortality was the largest inequality gap in three of the five HSC Trusts. In the Belfast and Western Trusts, the rates in their most deprived areas were almost two and a half times (132% and 130%) their respective Trust averages.
• Drug related mortality was among the top five inequality gaps within three of the eleven LGDs. In the Mid & East Antrim LGD, the rate of drug related mortality within the 20% most deprived areas, was almost treble (193%) the LGD average.
• Large inequality gaps for alcohol related admissions also exist in the majority of Trusts and LGDs. The rate in the respective most deprived areas for the Western Trust (112%), Derry City & Strabane LGD (113%), and Mid & East Antrim LGD (122%) was more than double the Trust/LGD average.
• Alcohol specific mortality showed the largest gap for the Southern Trust (102%), Causeway Coast and Glens LGD (121%), Lisburn & Castlereagh LGD (135%) and Newry, Mourne & Down LGD (65%).
• The under 20 teenage birth rate was the largest inequality gap in the South Eastern Trust (109%) as well as the Armagh City, Banbridge & Craigavon LGD (139%).
• The drug related admissions inequality gap was the largest in the Ards & North Down (103%) and Mid Ulster (66%) LGDs.