The 17th annual report ranks the Aloha State as the fourth healthiest in the nation, behind only Minnesota, Vermont and New Hampshire. Connecticut rounds out the top five in the annual report, while Louisiana and Mississippi rank as the least-healthy states.

The report is produced by United Health Foundation in partnership with the American Public Health Association and Partnership for Prevention. It is a yearly assessment of the relative healthiness of the nation, based upon analysis of comprehensive determining factors such as personal behaviors, the environment in which people live and work, the decisions made by public and elected officials and the quality of medical care delivered by health professionals.

The study study shows Americans' overall health improved slightly from last year, but the rate of improvement has leveled off since 2000.

Americans as a whole are only 0.3 percent healthier than they were at this time last year, the report said.

The increase is significantly lower than the nation's average annual improvement of 1.5 percent documented between 1990 and 2000, and only keeps pace with the 0.3 percent average annual national improvement since 2000.

The report also observes that the United States continues to trail other nations in important statistics such as healthy life expectancy and infant mortality.

"We as a nation are blessed with unparalleled resources and assets and as such it is troubling that we are not making more significant progress in overall health improvements," said Reed Tuckson, M.D., senior vice president of United Health Foundation. "This report is a call to action for all of us — as individuals, members of families, participants in community life, health professionals and political and policy leaders — to intensify our efforts toward a healthier America. We can do better and our children deserve better."

A national health analysis

Since America's Health Rankings began in 1990, the nation's overall health has improved by 18.7 percent. This national success can be attributed mostly to the reduction of several health determinants, such as infectious diseases, smoking, cardiovascular deaths, motor vehicle deaths and violent crime. In addition, there are slightly fewer children living in poverty, and more ninth graders are graduating high school within four years than in 1990. Each of these factors contributed positively to the nation's overall health status.

Since 2000, however, the rate of improvement in the nation's health status has essentially stagnated. Key reasons for this are the persistence of tobacco use and our nation's relatively high infant mortality rate. This stagnation is compounded by the increasing prevalence of obesity in America.

Obesity, which is up from 11.6 percent of the population in 1990 to nearly 25 percent today, is a precursor to many other diseases and plays a large role in hindering the nation's ability to improve its overall health status.

Finally, the report makes special note of the increase in the percentage of uninsured people, which has increased from 13.4 percent in 1990 to 15.9 percent of the population today. The increasing number of uninsured Americans has significant effects on the ability to prevent disease, in addition to impeding necessary medical care delivery.

A state-by-state analysis

The report's state-by-state analysis shows Illinois with the highest overall health improvement since last year (a 2.8 percent increase). Next are Ohio, with a 2.6 percent jump; Wisconsin, with a 2.3 percent increase; and Kansas, with a 2.1 percent rise. States with the greatest decline in overall health include New Mexico, which dropped 4.2 percent; Idaho, which declined by 3.9 percent; and West Virginia, which dropped 3.5 percent. But, regardless of where an individual state ranks, each state has its own set of successes and challenges.

"The rankings are a vital tool for every state to find opportunities to help citizens further improve their health," said John M. Clymer, president of Partnership for Prevention. "America's Health Rankings is more than a report; it is a call to action for states to implement healthful policies, since health is a critical factor in both quality of life and economic vitality."