All 12 Black Country constituencies and most of Staffordshire have fallen further behind London since 2019, with home affordability getting worse and the gaps in public sector spending and salaries widening.
Boris Johnson pledged to level up the country by reining in regional inequalities after storming to victory in the 2019 general election.
And he reiterated his Government's pledge on a visit to the West Midlands last week.
Labour says the report shows the PM's "rhetoric is not matched by the performance on the ground", while Tories in the region insisted the Government's policies would bear fruit given time.
Research by Bloomberg analysed 12 key economic metrics to see if levelling up has taken place since 2019.
Almost all areas across the Black Country and Staffordshire were said to be behind London in 2019 and either "falling or unchanged" since.
This was the case in areas including West Bromwich East, Walsall South and Dudley North in categories such as salaries, government investment, transport spending, productivity and life expectancy.
The only metrics that were consistently classed as levelling up in the region were universal credit and well-being, according to the report.
Wolverhampton South East MP Pat McFadden, Labour's Shadow Treasury Secretary, said: "Tackling regional inequality is a good aim, but this report shows there is a big difference between talking about it and delivering.
"The report shows that constituencies in the West Midlands are either standing still or falling further behind other parts of the country.
"The Prime Minister’s rhetoric is not matched by the performance on the ground, and ultimately that’s what counts."
Stuart Anderson, Conservative MP for Wolverhampton South West, said millions of pounds in Government investment would make a major difference in time.
"We are reversing generations of under investment in Wolverhampton," he said.
"We have received the Towns Fund, High Street Fund, Levelling up Fund and now the money is in we need to take time to see all of these funding streams change into real life projects in our city.
"Over time this and other investment will provide Wolverhampton with the tools it needs to level up and change the city for the better."
The Government's levelling up policy – devised by former Bank of England chief economist Andy Haldane and Levelling Up Minister Michael Gove – aims to move more money and decision-making powers away from London.
It pledges to hit a series of levelling up targets by 2030, including vast improvements to public transport systems and education standards.
In the Queen's Speech Mr Johnson pledged to use new landmark legislation to "grow our economy to address the cost-of-living, and level up opportunities for communities across the country".