Pregnancies in under-16-year-olds are a third higher in Plymouth and Swindon than the average for England and Wales, according to the first comprehensive report on inequalities and health in the South West region.
But in Bath and North East Somerset, under-age pregnancies are half the national average of 8.8 conceptions per 1,000 girls.
Managers have welcomed the report by the NHS Executive's south-west regional office, which shows a huge health gap between the richest and poorest in the region. Wiltshire health authority was positive about the report, which pulls together national and local data, for its insights into the 'wider picture'.
A spokesman said the HA was already extending family planning services in Swindon to tackle the area's high teenage pregnancy rate.
Avon HA said the report was 'very useful background information' for its own study on health inequalities.
Regional public health director Dr Gabriel Scally called on policy-makers to use the report to inform their decisions.
'In general, the health of the population is pretty good, but we have very serious problems of rural isolation and pockets of deprivation,' he said.
'This report provides comparative information across the South West. I hope HAs will respond to it by making social exclusion a top issue.'
The report provides a detailed picture of all aspects of society and economy in the South West that influence health, from early life experiences and stress to housing and transport.
Among 'profound' inequalities disclosed by the report, the poorest people have a death rate of 134 per cent the national average, which is also 64 per cent higher than among the richest in the region.
Inequalities and Health in the South-West Region. 0117-984 1832. Free.