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Dec 11, 2013 02:51 PM EST

Mississippi is the United States' least healthy state, according to the United Health Foundation's 2013 America's Health report.

An annual measure of the nation's health status revealed that although the country's health is improving overall, the well-being of the southern state has declined, USA Today reported.

The 27 measures of health analyzed by the United Health Foundation including smoking rates, crime rates, public health funding,  access to immunization and diabetes.

"People love rankings, and they do provide a real positive function," Steven Wallace, the associate director of the UCLA Center for Health Policy Research, which was not involved in the report, told USA Today. "Being at the top is reason to crow, and being at bottom is a real motivator for policymakers, public health officials and communities to say we can do a lot better than we have been."

Mississippi ranked in the bottom five states on 15 of the measures including high prevalence of obesity, physical activity and children in poverty. It scored well for having a low prevalence of binge drinking, a high rate of child immunizations and small disparity in health status between adults 25 and older who graduated from high school and those who didn't.

The state ranked last this year and ranked among the bottom three states since the inception of the rankings in 1990.

Hawaii came in first as this year's healthiest state.

Overall, major improvements were seen in more than two-thirds of the measures analyzed. The U.S. saw a decline in the smoking rate. This year it was down to 19.6 percent from 21.2 percent in 2012. Seventeen states had significant drops in smoking, the largest being in Nevada, Maryland, Oklahoma, Kansas and Vermont.

The country also saw a leveling off of the obesity epidemic as the percentage of adults who are obese - defined as roughly 30 or more pounds over a healthy weight - holds steady.

Reed Tuckson, senior medical adviser to the not-for-profit United Health Foundation, which sponsors the report with the American Public Health Association and the Partnership for Prevention, told USA Today this marks the first year since 1998 that obesity rates did not increase.

Tuckson called it a victory of sorts.

"We are encouraged," he said. "We are in no way declaring the war is over but are declaring that there is reason for optimism."

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