Years of universal healthcare, rising health spending, cancer screening, immunization and anti-smoking laws have failed to stop Britain falling behind its peers in reducing early death and disease, a study showed on Tuesday.

Researchers who compared Britain's health performance since 1990 with 14 European Union countries plus Australia, Canada, Norway and the United States said its pace of decline in premature death was "persistently and significantly" behind the average - a finding they described as "startling".

Chris Murray, who led the work at the University of Washington, said Britain's poor performance was partly due to dramatic increases in Alzheimer's disease and in drug and alcohol abuse problems, and to a failure to tackle leading killers such as heart disease, strokes and lung diseases.

"Concerted action is urgently needed," said Murray, director of the university's Institute for Health Metrics and Evaluation, whose study was published in the medical journal The Lancet.

Using data from a vast study called the Global Burden of Diseases, headline findings of which were published last year, researchers analyzed patterns of ill health and death in Britain, calculated the contribution of various preventable risk factors, and ranked it among high-income countries that spent similar amounts on health in 1990 and 2010.

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They found that only in men older than 55 years had seen significantly faster drops in death rates than other nations over the last 20 years.

Britain's ranking in premature mortality rates for adults aged between 20 and 54 had "worsened substantially", they found.

This was partly due to dramatic growth in problems linked to drugs and alcohol, which were ranked among the least important causes of death in this age group in 1990 - ranked 32nd and 43rd respectively - but rose to sixth and 18th place in 2010.

"Wake-up call"

Kevin Fenton, Director of Health and Wellbeing at Public Health England, who worked with Murray on the study, said the findings were "both a wake-up call and an opportunity".

"While it's encouraging that overall the health of the U.K. has improved substantially since the last report, the pace of improvement is not enough," he said in a statement.

The study found Britain's eight leading causes of death have changed little in the last 20 years, with heart disease, chronic obstructive pulmonary disease, stroke, lung cancer and lower respiratory infections remaining the top five.

There has been a startling increase Alzheimer's disease - which rose from 24th to 10th place - in cirrhosis, which is linked to alcohol abuse, and in drug use disorders. They rose from 14th to 9th position and from 64th to 21st respectively.

Andrew Chidgey of the Alzheimer's Society said he was sad but not surprised by the findings on rising cases of the brain-wasting condition. "With numbers soaring and costs trebling, we need urgent action to find more effective treatments," he said.

The study found that in 2010, Britain had significantly lower premature death rates from diabetes, road injuries, liver cancer and chronic kidney disease on average than other nations.

But it had not kept pace on rates of early death from other conditions such as heart and lung diseases, breast and esophageal cancer and pre-term birth complications.

Commenting on the findings, Edmund Jessop from the U.K. Faculty of Public Health in London said there was "plenty of room for bold action by politicians".

He said ministers should introduce tighter health policies such as plain packaging for cigarettes, a minimum price for alcohol, a ban on trans fats, improved control of hypertension and a greater focus on psychiatric disorders.

"Alternatively, the U.K. can continue to languish at the bottom of European league tables," he said.