Hawaii has the nation's healthiest residents in 2014 and Mississippi has the most unhealthy, according to the 25th annual America's Health Rankings, released Wednesday by the United Health Foundation.
Nationally, the annual report found that adult obesity rates increased 7 percent from 27.6 percent in 2013 to 29.4 percent this year. And the share of adults who had no physical activity in the last month increased from 22.9 percent in 2013 to 23.5 percent in 2014.
National smoking rates, however, fell by 3 percent in 2014, continuing a 10-year trend, while immunization rates for adolescents increased by 5 percent and infant mortality rates fell by 4 percent from 2013.
"We applaud hard-won advances in several key measures, including smoking prevalence, even as this year's America's Health Rankings is a solemn reminder that we have a lot more work ahead of us," said Dr. Reed Tuckson, senior medical adviser to the United Health Foundation, a nonprofit arm of insurer United Health Group.
Hawaii, which has never finished lower than sixth since the rankings were first released in 1990, notched the top spot with low rates of smoking, obesity, child poverty, preventable hospitalizations and deaths from cancer and cardiovascular disease.
Rounding out the 10 healthiest states were: Vermont at number two, Massachusetts, Connecticut, Utah, Minnesota, New Hampshire, Colorado, North Dakota and Nebraska at number 10.
Mississippi, which has never finished higher than 48th in the rankings, scored lowest for the third straight year, due in part to high rates of physical inactivity, low teen immunization rates and small disparities in health status by age.
After Mississippi, the bottom 10 states were: Arkansas at 49, Louisiana, Kentucky, Oklahoma, Tennessee, West Virginia, Alabama, South Carolina and Indiana at number 41.
The prevalence of impoverished Southern states at the bottom of the rankings has been a consistent trend for years.
Among the 10 unhealthiest states, only Arkansas, Kentucky and West Virginia have used the Affordable Care Act to expand Medicaid coverage to low-income people earning up to 138 percent of the federal poverty level.
Medicaid is the state/federal health insurance program for the poor and disabled.
The rankings by UHF are based on four health determinants: behaviors, community and environment, policy and clinical care. The scoring methodology was developed and reviewed by public health experts.
To view the 2014 America's health Rankings, go to http://www.americashealthrankings.org/reports/Annual
CORRECTION: An earlier version of this story gave the wrong date for when the report will be out. It was released Wednesday.