Muswellbrook is the Hunter's sickest town, with the region's highest number of premature deaths that could have been prevented by health service intervention, according to experts.
The Upper Hunter town had the largest number of "potentially avoidable deaths", with a rate significantly higher than the NSW average.
It ranked seventh worst out of 155 NSW local government areas, only behind the disadvantaged areas of Bourke, Brewarrina, Walgett, Moree Plains, Narrabri and Gwydir.
Gloucester is the Hunter's second sickest town, followed by Cessnock, Taree and Newcastle. All four towns had potentially avoidable death rates in people aged under 75, significantly higher than the NSW average.
Hunter New England Health's director of population health, planning and performance Kim Browne described the Hunter results as "worrying" and said heart disease, obesity, stroke, cancer and smoking were some of the biggest killers.
Ms Browne said potentially avoidable deaths were those that could have been prevented by earlier detection, intervention or treatment by health services.
She said the increase in the death rate was unfortunately linked to areas with significant socio-economic disadvantage, high indigenous populations and access to health services.
"Socio-economic disadvantage is unfortunately critical when looking at these deaths," Ms Browne said.
"We are talking about lifestyle interventions or earlier treatment or action by health services that could have made a difference in these cases."
According to the latest NSW Chief Medical Officer's report, Cessnock was the Hunter's most socially disadvantaged local government area in 2006-07, followed by Greater Taree, Great Lakes, Gloucester and Muswellbrook.
Muswellbrook Community Health Centre nurse unit manager Pearl O'Hara said the biggest concerns in the Upper Hunter were smoking and lack of physical exercise.
Ms O'Hara said there were a range of healthy lifestyle projects aimed at high-risk groups, but it was difficult to get some people to engage.
She said there was unfortunately a belief by many in Muswellbrook that they were "bulletproof"'.
"They do not see their smoking or other issues as a problem, which makes it very difficult to do something about it," she said.
"Women tend to be more interested in their health and we are aiming to get screening out to the public to reach the people who don't tend to access health services in an effort to make a difference and improve the situation."
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