Hazardous-drinking rates decreased with age, with peak rates seen in ages 15 to 24. Of that age group, 62 per cent of Hawke's Bay men had a hazardous-drinking pattern compared with the national average of 34 per cent.
The overall national rate was 15 per cent but in Hawke's Bay it was 24 per cent, with the hazardous-drinking rate amongst Maori men 59 per cent.
Flaxmere councillor Henare O'Keefe said Hawke's Bay health was in dire straits and communities needed to step up to the problem rather than wait for a solution from central government.
"I didn't realise we were in such a state - I had no idea it was as bad as that. The statistics seem to resonate out of low-decile areas. I think everybody needs to step up."
The region's wayward drinking culture could be addressed at the local level he said.
"The Government doesn't have the answers - we do. I propose we go back to 6 o'clock closing, we take alcohol out of supermarkets, we stop liquor sales on a Sunday and dedicate that day to our families. Extreme circumstances call for extreme measures."
Smoking was the leading cause of death-rate inequity. The national average of regular smokers was 15 per cent, the same for Hawke's Bay non-Maori, but 36 per cent of Hawke's Bay Maori smoked regularly.
Lung cancer was the leading cause of avoidable death among Maori women. With 46 per cent of pregnant female Maori who were smokers, the region had a "health crisis" because of the long-term effect on the next generation.
Maori suffered clear health inequity that was independent of socio-economic factors the report said, but where people lived had a clear bearing on health outcomes.
A Maori baby boy could expect to have a shorter life expectancy than non-Maori, and poorer health in years to come.
The report's author, director of population health, Caroline McElnay, said the most unexpected find was Hawke's Bay people were less physically active than the national average "despite all the region has to offer".
"I was so surprised at this finding I had the data revalidated," she said.
The report said a lack of physical activity was related to the region's high obesity rate. One in three adults was obese, with one in two Maori and two out of three Pasifika.
Tukituki MP Craig Foss said there was "no excuse for anybody not to exercise in the Bay".
"Our region is home to beautiful beaches, cycle trails and some fantastic initiatives promoting health and wellbeing, such as whanau-based gym Patu Aotearoa. It's important that we continue to encourage people to make healthy choices. It's about finding the right balance, especially with alcohol."
Napier MP Stuart Nash described the figures in the report as "statistics of deprivation".
"It reinforces my view that this Government really doesn't have a strategy for the regions, these are the diseases of poverty and the consequences of people being disenfranchised from society."
The report said people living in poorer areas such as Hastings' Camberley were three times more likely to die from an avoidable cause of death than people living in areas such as central Havelock North.
Mr Nash said he would be contacting Hawke's Bay DHB CEO Kevin Snee to see what could be done to address the region's health issues.
Dr McElnay said everyone in Hawke's Bay was affected by health inequity.
"For a difference to be made, we must tackle this collectively and take responsibility as a community."
Get help
• The Alcohol Drug Helpline: 0800 787 797
• Quitline: 0800 778 778
• Lifeline Aotearoa: 0800 543 354
• Depression Helpline: 0800 111 757
