Hawaii has yet again topped America's Health Rankings, a yearly accounting of the health of Americans, as the healthiest state in the U.S.

Mississippi, on the other hand, was named the least healthy state, which is somehow not surprising at all because the state has always been in the bottom three of the list ever since the rankings started in 1990. The state has high incidence of obesity, diabetes and infectious disease as well as low availability of primary care.

Hawaii, which made it as the healthiest state for the third consecutive time, has also been consistently in the top six of the ranking owing to its low prevalence of obesity, smoking, cancer related deaths and preventable hospitalizations albeit it also has some areas that need improvement such as the incidence of salmonella infections and binge drinking as well as immunization coverage.

The other states that made it to the top five healthiest were Vermont, which also ranked second for the third time in a row, Massachusetts at third, Connecticut at fourth and Utah to complete the top five. Mississippi was accompanied by Arkansas, Louisiana, Kentucky, and Oklahoma in the bottom of the list.

The annual report, the longest-running state-by-state analysis of the health of the nation, also revealed that Americans became fatter and became less engaged with physical activities. The rate of obesity among adults increased from 27.6 percent in 2013 to 29.4 percent this year. Physical inactivity in the last 30 days also rose from 22.9 percent to 23.5 percent.

There appears to be positive improvement in terms of smoking though with the number of Americans who smoke dropping by 3 percent. The number of adolescents who got immunization coverage likewise rose by 5 percent and infant mortality rates dropped by 4 percent.

Reed Tuckson, senior medical adviser to United Health Foundation, said that even with improvements in some key health measures such as the smoking rate, this year's America's Health Rankings show [pdf] that there are still lots of work to be done. The rising rate of diabetes, obesity and inactivity, for instance, is a concern.

He cited that the increased prevalence of obesity and the lack of physical activity can result in more people developing unwanted health conditions.

"It is inevitable that increases in the rates of obesity and physical inactivity will result in more people suffering from significant chronic diseases that compromise the quality of their lives, adversely affect their families and are unaffordable for the nation," Tuckson said.

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