Britain has a worse record of premature death from many diseases than other Western countries and the gap is widening, experts have warned.
Between 1990 and 2010 life expectancy in the UK increased by an average of 4.2 years to 79.9 years. But the trend masks worrying declines when matched against other nations with similar levels of health care, it is claimed.
In 1990 the UK ranked 10th in a league table of 19 countries showing years of life lost (YLL) per 100,000 members of the population. YLL is a standard method of measuring levels of premature death.
Twenty years later Britain had slipped to 14th in the table, with only five countries showing worse figures.
In terms of death rate (numbers of deaths per 100,000), the UK's position in the table fell from 12th in 1990 to 14th in 2010.
Some specific causes of death had a significantly increased impact over the two decades, including Alzheimer's disease, cirrhosis of the liver and drug use disorders.
For Britain the best news was that it saw the largest fall in death rates from heart disease of any of the 19 countries.
Scientists compared the UK's record for a range of important health indicators with that of 14 other European Union countries, plus Australia, Canada, Norway and the US.
Data was drawn from the Global Burden of Disease Study, published in 2010. The results covered 259 diseases and injuries, and 67 risk factors or risk factor clusters.
Outlining their findings in The Lancet medical journal, the international authors pointed to the biggest individual risk factors for illness and disease in the UK.
Heading the list was tobacco, accounting for 12% of the disease burden, followed by high blood pressure, high body-mass, physical inactivity, alcohol and poor diet.
Levels of disability at specific ages had not improved in the UK over the 20 year period, the study found.
This was a problem shared to a greater or lesser degree by all the countries. Major causes of disability varied by age but included mental and behavioural disorders such as depression, anxiety, psychosis, substance abuse and osteoarthritis and other musculoskeletal problems.
Across all ages, the top eight diseases responsible for the most years of life lost in the UK remained largely the same in 2010 as those reported in 1990.
In order, these were heart disease, lung cancer, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, bowel cancer, breast cancer and self harm. Years of life lost from drugs increased nearly six-fold over the 20 year period.
Co-author Professor Kevin Fenton, director of health and wellbeing at the new Government agency Public Health England (PHE), said the report was a "wake up call" for the UK.
He added: "The reality is that nearly all of these conditions are either preventable or amenable to early intervention, providing opportunities to make a substantial difference in people's lives, and reduce the tremendous psycho-social and economic burden of poor health on our society.
"Ultimately, in order to really make a difference in improving our nation's health, concerted action will be required, with individuals, families, local communities, local councils, the NHS and government all taking responsibility and working together towards a healthier population."
Professor John Newton, chief knowledge officer at PHE, said: "These relatively poor results for mortality and disability in the UK require a response at every level and from all responsible authorities. For example, the data on contribution of different risk factors clearly show the need to redouble our efforts on smoking, high blood pressure and obesity. The NHS must pay more attention to prevention and early intervention but the underlying causes often have little to do with health care."
Health Secretary Jeremy Hunt has previously pledged to cut the number of avoidable deaths from cancer, heart disease, strokes, respiratory and liver disease.
"Despite real progress in cutting deaths we remain a poor relative to our global cousins on many measures of health, something I want to change," he said.
"For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around."
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