The United States places last among 19 industrialized countries when it comes to deaths that could have been prevented by access to timely and effective health care, according to a new study published in the January/February issue of the journal Health Affairs.

France finished first when it came to preventable deaths, followed by Japan and Australia.

In “Measuring the Health of Nations: Updating an Earlier Analysis,” Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine compare trends in preventable deaths for the years 1997-1998 and 2002-2003.

While other nations dramatically improved preventable death rates between 1997-1998 and 2002–2003, the U.S. improved just slightly, the researchers said.

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If the U.S. had performed as well as the top three countries identified in the study, there would have been 101,000 fewer deaths in the U.S. per year by the end of the study period, the authors said.

Nolte and McKee found that while other countries saw preventable deaths decline by an average of 16 percent during the study period, the U.S. experienced only a 4 percent decline.

The authors noted that the U.S. preventable mortality rate coincided with an increase in the country's uninsured population.

“It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,” said Cathy Schoen, senior vice president of the Commonwealth Fund, which funded the study. “The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference.”

In 1997–1998, the U.S. ranked 15th out of 19 countries on preventable deaths, but fell to last place in 2002-2003 with 109 preventable deaths for every 100,000 people.

In contrast, mortality rates per 100,000 people in the leading countries were: France (64), Japan (71), and Australia (71). The other countries included in the study were Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden and the United Kingdom.