Life expectancy is five years lower in Cornwall's most deprived areas
Men living in Cornwall's most affluent towns and villages enjoy a lifespan six years longer than those in its poorest parts.
The stark difference in life expectancy is spelled out in the latest annual report by the county's director of public health, Felicity Owen.
The snapshot of what it means to be healthy in Cornwall draws a picture of a county divided.
"It is dramatic," said Ms Owen.
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"The difference is stark and it is critical that we close this gap and bring it up so that everybody in Cornwall has the same life chances.
"The county's logo is One and All and we have just got to do better."
According to the report, life expectancy is 5.9 years lower for men and 5.2 years lower for women in the most deprived areas of Cornwall than in the least deprived areas.
Ms Owen said issues like poverty and education all play a part.
"In some areas it is very common to smoke and you see lots of people doing it, but then in other parts you hardly see anyone smoking at all.
"Smoking accounts for 50% of the difference in life expectancy.
"The evidence is that people in higher paid jobs and who have gone to university are much more likely to give up smoking and take on board the healthier living message."
Ms Owen said that alcohol, obesity and simply not having enough money were all factors in the lower life expectancy in poorer areas.
The report also revealed that just over 15% of Cornwall's 10-11 year-olds are obese, lower than the national average.
Meanwhile levels of GCSE attainment and alcohol-specific hospital stays among those under 18 are worse than the England average.
The report says that the health of people in Cornwall is a mixed bag compared with the England average. Deprivation is lower than average, although it is estimated that around 17,000 children live in poverty.
Early death rates from cancer and from heart disease and stroke have fallen and are better than the England average, although the incidence of skin cancer is higher than average.
In general, life expectancy for both men and women is better than the England average.
However Dr Owen said work was vital to reduce inequality by tackling poverty, improving housing, boosting the amount of exercise people take and reducing harmful drinking.
"We are seeing some great improvements but as a county there is still a lot of inequality and there is a lot of work to be done to close that gap."