Health inequalities are entrenched in this country and life expectancy has been getting worse in the poorest areas. This was brutally exposed during the covid pandemic when people under 65 in the poorest parts of the country were four times more likely to die. Now, as we face the cost of living crisis and the NHS faces increased pressures, we risk things becoming worse still. This report focuses on healthy life expectancy (HLE) - the age which people can expect to reach in good health. This research was designed to support the stated ambition of the government: “By 2030, the gap in healthy life expectancy (HLE) between local areas where it is highest and lowest will have narrowed, and by 2035 HLE will rise by 5 years.” We do this by exploring what people who live in areas of very low HLE want to see change and understanding the case for action. To do this, we conducted 6 focus groups in very low HLE areas and a nationally representative poll. We find that people in low HLE areas have a holistic view of what makes their place healthy, and want action on crime, green spaces and a greater sense of community - as well as improvements to health services. There is a wide and nuanced understanding of health inequalities but the public don’t see anything happening and don’t trust it will happen in the future. This political failure may be punished at the ballot box if action isn’t taken, but there are also political opportunities for parties willing to step up. Policies to tackle health inequalities - like expanding screening, and improving access to green spaces - are popular and could help political parties attract new voters in the coming election.