Hawaii ranks fourth among U.S. states in overall health, according to the 2011 America's Health Rankings released Tuesday by the United Health Foundation in collaboration with the American Public Health Association and Partnership for Prevention.
Hawaii is up from a fifth-place ranking in 2010.
Some of Hawaii's strengths in the ranking are low levels of pollution, lower prevalance of obesity than all other states and a low prevalance of diabetes.
The report says some of the challenges in Hawaii are low use of early prenatal care, high geographic disparity within the state and low immunization coverage.
"Hawaii?s improved ranking is a positive reflection of the overall health of our residents, but there are still many areas where we need to continue to work together to help people make healthier choices, break down the barriers to quality care and create positive health changes in the community," said David W. Heywood, vice president, UnitedHealthcare of Hawaii.
For the fifth year in a row, Vermont was the nation?s healthiest state.
States that showed the most substantial improvement include New York and New Jersey, both moving up six places.
Idaho and Alaska showed the most downward movement. Idaho dropped 10 spots, from number nine to 19 in this year?s rankings, and Alaska dropped five places.
For more on Hawaii's health ranking, click on the AHR Hawaii 2011 Ranking.