LONDON (AP) -- Despite six decades of free medical care and widespread health campaigns, Britons are among the unhealthiest people in Western Europe, a new study says.

International researchers analyzed the country's rates of sickness and death from 1990 to 2010 in comparison to those of 15 other Western European countries in addition to Australia, Canada and the U.S. Experts described the U.K. results as "startling" and said Britain was failing to address underlying health risks in its population, including rising rates of high blood pressure, obesity and drug and alcohol abuse.

"It's incredibly surprising," said Dr. Christopher Murray, who studies health metrics at the University of Washington in Seattle and is the lead author of the latest report.

"We all think of the U.K. as having a great health system and as one of the most sophisticated medical research communities in the world," he wrote in an email. "Nobody would have really expected that the U.K. would be toward the bottom."

Overall, the U.K. was 12th for healthy life expectancy, with most Britons expected to live 68.6 years in good health. The United States came in 17th out of 19 countries with 67.9 years. Spain topped the charts with a healthy life expectancy of 70.9, while Finland came last, with most Finns likely to live 67.3 years in good health. Australia ranked third with 70.1 years, while Canada was fifth with 69.6 years.

In terms of years of life lost to health conditions, Britain ranked just above last place for serious respiratory infections, preterm birth complications, and breast cancer. In comparison, Italy had the lowest death rates from respiratory infections while Norway was best at handling birth complications. Sweden had the lowest death rates for breast cancer.

Murray and colleagues said there was virtually no change in the rate of premature deaths among British adults aged 20 to 54 but found a spike in deaths caused by drug and alcohol abuse for that age group. Cirrhosis, or liver disease often linked to alcohol consumption, has jumped by more than 65 percent in Britain in the last two decades, prompting a recent government proposal to crack down on cheap drinks by setting minimum prices.

As in most Western nations, heart disease, stroke and cancer were the leading killers and in the U.K. there were higher death rates from those compared to other developed countries studied. The research was paid for by the Bill & Melinda Gates Foundation and was published online Tuesday in the journal Lancet.

"In some areas like tobacco control and road safety, we have done very well," said Edmund Jessop of the U.K. Faculty of Public Health in London, who wrote an accompanying commentary. But he said it was worrying that Britain was lagging behind many other European nations with similar income levels and socialized health care systems.

Jessop called for British officials to take "bold action" to tackle issues including alcohol consumption and obesity, "otherwise there will be serious consequences and the U.K. could remain at the bottom."

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