For the fourth consecutive year, sunny and beach-laden Hawaii emerges as the healthiest state in the country.

The list is a comprehensive report from the United Health Foundation and the American Public Health Association that has ranked the states' overall health for the last 26 years. It is based on the WHO definition of health: complete physical, mental, and social well-being, including levels of exercise, crime data, high school graduation rate, and public health funding.

Aside from Hawaii bagging the top spot in 2015, North Carolina showed the biggest improvement, rising from the 37th to the 31st place mainly due to lower physical inactivity rate and a 65 percent climb in HPV immunization among teenage girls.

In the top 10 list were Hawaii, Vermont, Massachusetts, Minnesota, New Hampshire, Connecticut, Utah, Colorado, Washington, and Nebraska.

The U.S. as a whole improved in areas such as preventable hospitalizations, reductions in physical inactivity, rises in child and teen immunization, continued long-term gains in less cigarette smoking, fewer cardiovascular fatalities, and lower infant mortality.

Only 18.1 percent of adults, for instance, smoked (down from almost 30 percent in 1990) and violent crime dipped 51 percent in the last two decades.

The report found some “troubling” increases in drug death, diabetes, obesity, and child poverty rates. In the last two years, obesity increased to 29.6 percent from 27.6 in adults, while 10 percent of the adult population reported having diabetes. Death from drugs is up 4 percent to 13.5 for every 100,000 individuals, while child poverty rose from 19.9 to 21.1 percent.

“Premature death rates have plateaued; many of these deaths are preventable through lifestyle modifications,” the report stated.

New England also surfaced as one of the winners, with four out of its six states consistently landing in the top 10 healthiest states. Both Louisiana and Mississippi, on the other hand, struggled with physical inactivity and obesity, with the former edging out the latter – 2014’s bottom-ranked state – in this year’s results.

In the international arena, however, it appeared the U.S. has plenty of work ahead compared to its high-income counterparts. Its infant mortality and life expectancy levels, for instance, are deemed poor compared to Japan, Singapore, New Zealand, and many West European countries.

Photo: Nan Palmero | Flickr

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