AS health inequality between rich and poor becomes a growing problem, the Government is coming under increasing pressure to tackle it at its roots. Today and tomorrow Brighton plays host, for the first time, to a Public Health Forum designed to explore this and other issues in depth. And as delegates prepare to debate the link between poverty and sickness, local health chiefs are unveiling the results of their own research on the same theme. JAMES MORRISON reports.

DAY in, day out, the experts tell us we are all getting healthier.

Focusing on improved diet, hygiene and medical treatment, they show us in no uncertain terms how much more lucky we are than our forebears.

But while this generalisation may be true for the majority of the population, there are those whose health is scarcely better than it would have been a century ago.

While more and more people go to the gym on a regular basis, or experiment with other forms of healthy living, a growing number are falling through the lifestyle net.

Over the next two days, these, and a range of related issues, will be discussed in detail at the annual Public Health Forum in Brighton.

Among the speakers will be prominent academics and politicians, including Health Secretary Frank Dobson, who it is hoped will outline the gist of the Government's long-awaited Public Health White Paper.

But beyond all the fine words and rhetoric, will the conference actually influence policy to improve the lot of the disenfranchised few?

Donald Reid is chief executive of the Association for Public Health, which later this week will merge with The Public Health Alliance to form a strengthened fighting force intent on spreading the benefits of healthier living.

He said: "This is the first time we've been to Brighton, but it's our seventh year. Originally, we started out with about 150 delegates only, but now we're expecting upwards of 700.

"What these people come along for is to hear how successful others have been in getting their ideas implemented, and it's clear that, as far as the Department of Health is concerned, people are starting to listen."

He added: "But what we are about is finding out how to do better for groups of deprived and isolated people. One example could be travellers, who, because of their lifestyle, might be exposed to more risks and yet become more cut off from normal GP health care."

This year's seminars will focus squarely on three main areas determined by recent Government announcements.

First up is the newly-published Acheson Report which points to gross inequalities in standards of public health between rich and poor areas.

Also on the agenda are the new Health Action Zones, set up to address such issues in badly affected areas, among them Brighton and Hove, and the healthy living centres ministers promise will soon be on every major high street.

Mr Reid said: "One of the people involved in this year's parallel sessions will be Richard Wilkinson, who is based at Sussex University's Trafford Centre of Medical Research, and he believes that it's not just being poor that makes you unhealthy: it's being poor while you are surrounded by rich people.

"You could have a young man of 22, for instance, who's unemployed much of the time and feels the rest of the world is accelerating away from him, so he feels the only way to go is to start taking drugs."

East Sussex, Brighton and Hove Health Authority is taking very seriously the findings of its own recent research into public health inequalities, which make for shocking reading.

In a county traditionally seen by central Government as being of relatively low priority need, there is a consistently above average number of old, and hence vulnerable, people.

Ahigh reliance on service industries has led to an unstable job market, and a level of unemployment which has been higher than the UK rate since 1991.

More worrying still, the number of homeless people has doubled since 1981 alone, leaving thousands at the mercy of the elements and without easy access to health care.

The authority's research has also found that Hastings has the 29th highest rate of teenage pregnancies of all 366 local authority areas in England and Wales, with 13 per 1,000 of the population occurring between 1993 and 1995.

Mental health needs also vary widely from area to area, with Brighton's Regency ward and St Leonards having an above average number of people with enduring problems linked to poor living conditions.

And to make the statistics even more grim, 56 per cent of deprived wards were found to have inadequate access to treatment.

In the past, such glaring gaps in standards of public health were associated with differences in behaviour between social classes.

But Dr Graham Bickler the health authority's director of public health and author of the report, feels there are more subtle reasons for this great divide.

He said: "Differences in people's behaviour are important, but it's too easy just to say, 'it's your fault: you smoke' to people, and see organisations as just being there to make policy.

"But what we need to do is work more closely with other organisations who are in a position to help improve public health, and identify ways of enabling people to participate more actively in society."

The Public Health Forum kicks off at the Brighton Centre this morning at 9am and ends tomorrow at 5pm.

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