On 14 October 2025, the CSO released Income Analysis Using Administrative Data Sources. This frontier release was based on linked administrative income data with the 2022 Census population living in private households. Equivalised income estimates from this publication were linked to household geolocation data, allowing distances to health services to be analysed by income level.
Equivalised income allows for more meaningful comparisons of income across households by adjusting for the number of adults and children living in the household, enabling analysis at an individual level. Equivalised income is then grouped into ten equal bands (deciles), in ascending order of income. When interpreting results by individual characteristics, it should be noted that equivalised income reflects the combined income of all household members. In this chapter, income deciles are defined using the national distribution of equivalised household income. When presenting results at lower levels of geography, individuals remain classified according to their national income decile; income deciles are not recalculated within each geographic area. Further information is provided in the Background Notes of this release.
At State level, individuals in the highest equivalised net administrative income decile (tenth), had shorter median distances to regional health services than those in all other income groups. For instance, the median distance to a HSE Emergency Department or Injury Unit for those with income in the tenth decile was 6.6 km, compared with 13.0 km for those in the first decile. Differences in distance to services by income decile were minimal for local health services, with the median distance to a Pharmacy 1.1 km for individuals in the first income decile, compared with 1.0 km for individuals with income in the tenth decile.
At Administrative County level, median distances to regional health services were broadly similar across income deciles in most Administrative Counties, with little variation between the lowest and highest income bands. In Sligo County and Wicklow County, median distances to regional health services decreased as income decile increased, consistent with the pattern observed at State level. However, in Limerick City and County, the highest median distance to a HSE General Hospital was among those in the sixth income decile (12.0 km), while the lowest median distances were among those in the first income decile (4.3 km) and the tenth income decile (6.5 km).
For the purposes of Local Authority elections, each county and city are divided into Local Electoral Areas (LEAs). For further information see Census 2022 Small Area Population Statistics.
In Conamara North and Conamara South in Galway, median distances to a HSE General Hospital decreased as income decile increased. The difference was most pronounced in Conamara North, where half of all individuals in the first income decile lived more than 65.2 km from a HSE General Hospital, compared with 27.1 km for those in the tenth income decile.
In Tramore-Waterford City West in Waterford, median distances to a HSE Maternity Department were broadly similar among individuals in the first to fourth income deciles, at under 8.0 km. From the fifth decile upwards, median distances increased to 11.6 km. Half of all individuals in the tenth income decile lived more than 12.3 km from a HSE Maternity Department, which was twice the median distance for those in the first income decile (6.2 km).
This section uses the six-category urban and rural classification set out in the CSO release Urban and Rural Life in Ireland, 2025.
Analysis by degree of urbanisation shows that ‘Independent Urban Towns’ had the most pronounced income-related differences in distance to a hospital as individuals in the tenth income decile lived less than a quarter of the distance to a HSE General Hospital than those in the first; half of all individuals in the tenth income decile lived within 5.6 km to their nearest HSE General Hospital, compared with 20.5 km for those in the first income decile.
A more modest difference was evident in ‘Rural areas with high urban influence’, where distances to the nearest HSE General Hospital fell from 19.7 km in the lowest income decile to 16.7 km in the highest. In ‘Rural areas with moderate urban influence’ and ‘Highly rural/ remote areas’, distance to a HSE General Hospital varied little across income deciles, ranging from 26.6 km to 25.2 km and 34.2 km to 31.0 km, respectively.
There are six HSE Health Regions, each responsible for both hospital and community care: Dublin and North East, Dublin and Midlands, Dublin and South East, South West, Midwest and West and North West. Further information on the counties within each region is available in the Background Notes.
Median distances to health services showed little variation across income deciles by HSE Health Regions. For HSE Maternity Departments, however, median distances generally decreased as income decile increased. In the HSE South West Health Region, the median distance to a HSE Maternity Department fell from 24.8 km in the first income decile to 14.5 km in the tenth. A contrasting pattern was observed in the HSE Midwest Health Region for GP access, where median distances increased as income decile increased. Individuals in the first income decile had a median distance of 1.2 km to their nearest GP, compared with 2.3 km for those in the ninth decile and 2.1 km for those in the tenth decile.
While generally, median distances decreased as income decile increased, some nuances were observed when interrogating distances by HSE Integrated Healthcare Areas (IHAs), which provide a more granular geographic breakdown than HSE Health Regions. The most pronounced differences in median distance to GPs were in HSE Midlands (1.6 km to 3.2 km), HSE Carlow Kilkenny and Tipperary South (1.7 km to 3.5 km), HSE Waterford Wexford (1.9 km to 3.4 km) and HSE Clare and Limerick County (1.7 km to 3.1 km) - in all cases those in higher income deciles lived further from their nearest GP.
In several IHAs, median distances to a GP were lowest among individuals in the lowest and highest income deciles, with distances peaking among those in the middle income deciles. HSE Galway Roscommon is the clearest example (1.7 km rising to 3.2 km before falling back to 1.9 km), as is HSE Kerry (2.7 km rising to 4.1 km before falling to 3.2 km).
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