Louisiana has replaced Mississippi as the least healthy state in 2018 according to a new report released by the United Health Foundation.

Smoking, obesity, poverty, mental health and low birth weight were all factors contributing to the low score.

The reason for the 50th placement is due to multiple shortfalls in health and medicine including:

• Highest prevalence of children in poverty at 28.0 percent, compared with 18.4 percent nationally.
• High prevalence of smoking at 23.1 percent of adults, compared with 17.1 percent nationally.
• High prevalence of obesity at 36.2 percent of adults, compared with 31.3 percent nationally.
• High prevalence of frequent mental distress and frequent physical distress at 16.1 and 16.5 percent of adults, respectively, compared with 12.0 percent for each nationally.
• High percentage of low birthweight babies at 10.6 percent of live births, compared with 8.2 percent nationally.

The study did point out some “bright spots” where the bayou state is doing well:

• High number of mental health providers at 271.9 providers per 100,000 population, compared with 234.7 per 100,000 nationally.
• Low incidence of pertussis at 1.4 new cases per 100,000 population, compared with 5.6 per 100,000 nationally.
• High HPV immunization coverage among females aged 13 to 17 at 64.3 percent, compared with 53.1 percent nationally.
• High Tdap and meningococcal immunization coverage among adolescents at 90.1 percent and 89.0 percent, respectively, compared with 88.7 percent and 85.1 percent nationally.

Other states in the bottom five are Mississippi (No. 49), Alabama (No. 48), Oklahoma (No. 47) and Arkansas (No. 46). Most of the healthiest states are in the Northeast. States ranking least healthy are mostly in the South.

Texas was ranked 37th, falling from 34th in the report from last year.

Hawaii was ranked the most healthy state for the fourth time in the last five years and for the ninth time since 1990. Massachusetts is No. 2, Connecticut No. 3, Vermont No. 4 and Utah No. 5.

For the first time since the report began 28 years ago, more than 30% of American adults were found to be obese.