The United States ranks worst among developed nations in the number of preventable deaths, according to a study conducted by researchers from the London School of Hygiene and Tropical Medicine and published in the journal Health Affairs.

Researchers tracked how many preventable deaths took place in 19 developed nations between 2002 and 2003. A preventable death was defined as one that would not have occurred if the patient had access to timely and effective health care.

The United States ranked dead last, with 109.7 preventable deaths for every 100,000 people. France came in first, with 64.8, followed by Japan and Australia, with 71.2 and 71.3, respectively.

Following Australia, in order, were: Spain, Italy, Canada, Norway, the Netherlands, Sweden, Greece, Austria, Germany, Finland, New Zealand, Denmark, Britain, Ireland, Portugal and the United States.

If the U.S. health care system functioned as well as that of France, 101,000 fewer people would die each year, the researchers found.

According to researcher Ellen Nolte, the poor showing of the United States came largely from the large number of U.S. residents that lack health insurance - 47 million, or more than 15 percent.

"I think health care in the United States is pretty good if you have access," Nolte said. "But if you don't, I think that's the main problem, isn't it?"

In preventable death data from 1997-1998, France and Japan still ranked first and second, respectively. At that time, the United States ranked 15th.

The drop in the U.S. ranking came from the fact that while preventable deaths decreased an average of 16 percent in the 19 countries between 1998 and 2003, the U.S. decrease was only 4 percent.

"It is startling to see the United States falling even farther behind on this crucial indicator of health system performance," said Cathy Schoen, senior vice president of the health policy foundation Commonwealth Fund, noting that "other countries are reducing these preventable deaths more rapidly, yet spending far less."