Healthiest and least healthy states ranked for 2018

With the new year fast approaching, getting healthy is at the top of many people's lists of resolutions. While a healthy diet and exercise are key to good health, where you live may also be a factor.

A new report ranks the healthiest – and least healthy – states. It finds that Hawaii has reclaimed the title of healthiest state in 2018, after dropping to number 2 in 2017. Other exceptionally healthy states include Massachusetts, Connecticut, Vermont, and Utah.

At the bottom of the list, Louisiana ranks number 50 this year, replacing Mississippi as the state with the greatest health challenges.

The report titled America's Health Rankings Annual Report, from the United Health Foundation, a nonprofit division of UnitedHealth Group, has been published every year since 1990. To calculate the rankings, researchers used 35 health measures in the categories of behaviors, community and environment, policy, clinical care, and health outcomes.

The top 10 healthiest states on the list:

1. Hawaii
2. Massachusetts
3. Connecticut
4. Vermont
5. Utah
6. New Hampshire
7. Minnesota
8. Colorado
9. Washington
10. New York

Factors that helped Hawaii nab the top spot include its lower-than-average rates of obesity, smoking, and frequent mental distress, as well as low levels of air pollution and high number of primary care physicians.

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State health rankings for 2018. Rank based on weighted sum of the number of standard deviations each core measure is from the national average. United Health Foundation

States ranking on the other end of the spectrum as the least healthy are:

50. Louisiana
49. Mississippi
48. Alabama
47. Oklahoma
46. Arkansas
45. Kentucky
44. West Virginia
43. South Carolina
42. Tennessee
41. Indiana
40. Ohio

Louisiana fared worst in large part due to its high levels of children in poverty, smoking, obesity, frequent mental and physical distress, as well as many babies born with low birthweight.

Generally, the healthiest states in the ranking are in the Northeast, with a few in the Midwest and West. States ranked as least healthy are in the South with the exception of Indiana and Ohio.

Obesity and chronic diseases

For the first time in since the report was was introduced 28 years ago, it found more than 30 percent of the U.S. adult population is obese. Since 2017, the prevalence of obesity increased 5 percent, from 29.9 percent to 31.3 percent of adults.

Premature deaths are also rising, increasing 3 percent over the past year. The researchers say higher numbers of drug-related deaths, suicide rates, and occupational fatalities are driving this grim trend.

Cardiovascular death rates also continue to increase, rising 2 percent in the latest survey. The number of people reporting frequent mental distress and physical distress are also rising, the report found.

What's moving in the right direction?

Overall, the United States has seen some positive trends in recent years. The percentage of children living in poverty decreased from 22.6 percent in 2013 to 18.4 percent in 2018.

Air pollution levels have also been decreasing nationally, dropping 12 percent from 9.5 to 8.4 micrograms of fine particles per cubic meter since 2015.

While there are still barriers to health care for many Americans, the number of mental health and primary care physicians per 100,000 people is increasing. In the past year, the number of mental health providers increased 8 percent while the number of primary care physicians increased 5 percent.

Finally, the rates of adolescent immunizations are on the rise. In the past year, HPV immunization among male teens age 13-17 increased 18 percent, a significant jump from 37.5 percent to 44.3 percent. The rate for females in the same age group increased 7 percent, from 49.5 percent to 53.1 percent.