The Department of Health has published its Health Inequalities Annual Report 2026, and the findings demand attention. 

The report paints a stark picture of the reality facing many communities across Northern Ireland. The gap in female healthy life expectancy between the most and least deprived areas now stands at 14.6 years. Gaps in avoidable and preventable mortality have widened across a number of indicators. Data on drug‑related deaths and childhood obesity continues to show that the same communities are living with sustained, long‑term and systemic pressure. 

These are not marginal trends. They are clear signals that, despite long‑standing recognition of health inequalities, the conditions shaping people’s lives and health outcomes remain deeply unequal. 

Why this matters for the VCSE sector 

For the voluntary, community and social enterprise (VCSE) sector, this report is not background reading. It is the evidence base for the conversations we are having every day with commissioners, policymakers and health and other planners about where investment is needed, why it matters, and how services are designed and delivered. 

VCSE organisations are embedded in the communities most affected by inequality. They see, first‑hand, how poor health outcomes are shaped not by individual choices alone, but by wider factors such as poverty, insecure work, poor housing, limited access to services, and social isolation. The 2026 report reinforces what the sector has long known: that without sustained, preventative and community‑led approaches, inequalities will continue to widen. 

From life expectancy to healthy life expectancy 

One of the most striking findings in this year’s report is the focus on healthy life expectancy. While life expectancy remains an important measure, healthy life expectancy tells us far more about people’s quality of life. A 14.6‑year gap for women between the most and least deprived areas highlights not only how long people live, but how long they live in good health. 

This finding should fundamentally shift how success is measured within health and social care. Years spent living with poor health, disability or long‑term conditions place pressure not only on individuals and families, but on services and communities. Addressing this gap requires action far earlier in the life course and far closer to where people live. 

The case for prevention and early intervention 

The widening gaps in avoidable and preventable mortality underline the urgency of prevention and early intervention. Rising drug‑related deaths and persistent childhood obesity inequalities point to challenges that cannot be resolved through health services alone. 

Community‑based, preventative support is critical to breaking these cycles. This includes services that build trust, support mental wellbeing, reduce isolation, promote healthy behaviours, and help people navigate complex systems before crisis point is reached. The VCSE sector already plays a vital role in delivering this support, often with limited and short‑term resources. 

NIHC’s position: place‑based, partnership approaches matter 

At the Northern Ireland Health Collective (NIHC), we believe that place‑based, partnership approaches are central to closing health inequality gaps. This means services designed around communities, delivered in partnership across sectors, and informed by lived experience. 

However, place‑based working on its own is not enough. The findings of the 2026 report also reinforce the need for systemic change to address the wider determinants of health. This includes: 

• Economic stability, including income security and good‑quality work 

• Educational access and quality across the life course 

• Neighbourhoods and the built environment, including housing, transport and green space 

• Social and community context, including connection, participation and trust 

Health inequalities cannot be reduced by the health system acting alone. They require coordinated action across government, public services, communities and the VCSE sector. 

A renewed focus on inequality 

This year’s Health Inequalities Annual Report is a timely reminder that tackling inequality must remain a shared priority. The evidence is clear. The challenge now is to ensure that action matches the scale and urgency of the findings. 

NIHC will continue to work alongside our members and partners to: 

• Champion the role of VCSE organisations in prevention and early intervention 

• Advocate for investment that follows need and supports community‑led delivery 

• Strengthen partnership approaches that address both health outcomes and the wider determinants of health 

Reducing health inequalities is not a quick fix. But with sustained commitment, genuine partnership and a focus on communities most affected, progress is possible.