WALES' health inequalities are laid bare in chief medical officer Dr Ruth Hall's annual report, issued today. It reveals wide discrepancies in life expectancy and death rates in different parts of Wales. Health reporter Andy Rutherford reports.

WE are all living longer. Men in Wales are on average, expected to live 74.8 years, almost two years longer than they were in 1990.

Women, meanwhile, have double cause to celebrate. Not only do they live on average around five years longer than men, but they are living 1.2 years longer than they were expected to in 1990.

But where you live can dramatically influence your life expectancy. Ceredigion residents live the longest lives, on average 79 years, while the people of Merthyr Tydfil have the shortest life expectancy at 74-and-a-half years.

But though the difference is less, the inequality is perhaps at its sharpest in two parts of Gwent. Monmouthshire folk enjoy the second longest lives in Wales on average, while their neighbours in Blaenau Gwent live the second shortest lives.

It is precisely this discrepancy, and big differences in mortality rates, that health experts are seeking to overcome.

All the facts and figures about good and bad health, death rates for heart and respiratory diseases, cancers, smoking, drinking, poor diet, the effects of deprivation, conspire to effect how long we live.

Blaenau Gwent fares badly in the majority of these, compared to other parts of Wales, while Monmouthshire largely does well. The areas' differing social and economic histories provide many of the reasons.

While Monmouthshire is largely rural and affluent, Blaenau Gwent could hardly be more different.

Countless thousands of men in Blaenau Gwent worked in the coal and steel industries, often in very poor conditions and many are still paying the price in terms of their health. The obliteration of these industries - which will be completed by the closure of the Ebbw Vale tinplate works this summer - has in turn brought deprivation and a knock-on effect on health and lifestyles.

Figures, released as part of the annual report of Wales' chief medical officer Dr Ruth Hall, indicate that things are improving.

The challenge now is to bring life expectancy in the most deprived areas, such as Blaenau Gwent, up to that enjoyed in the likes of Ceredigion and Monmouthshire.

Citing the increase in life expectancy as a sign of improvement, Assembly health minister Jane Hutt said partnership is the way forward in tackling ill-health and health inequalities. "The chief medical officer emphasises that a broad approach is needed to improve health in Wales with everyone, including local government and the voluntary sector as well as the NHS, playing their part," said Ms Hutt.

A key aspect of that "right approach" will be Local Health Boards which take over from Wales' health authorities in April 2003.

The aim is a more locally accountable NHS - geared to tackling the specific health problems of different parts of Wales.