North Carolina slipped to 35th place nationwide in the United Health Foundations annual survey of Americans health.
The state, which ranked 34th in 2012, is plagued by a high infant mortality and low public-health funding compared to other states. A quarter of the states adults 1.8 million people lead physically inactive lifestyles, the foundation said this week.
The rankings compare states to each other by a variety of measures culled from federal databases.
The nations healthiest state is Hawaii, which edged out Vermont this year. The poorest health ranking went to Mississippi, at the bottom of a pack of other Southern rural states: Arkansas, Louisiana, Alabama and West Virginia.
The health rankings are based on data from the Centers for Disease Control and Prevention, American Medical Association, U.S. Census Bureau, U.S. Department of Education and the Federal Bureau of Investigation.
North Carolina continues to struggle with a limited availability of dentists in rural areas, babies born with low birth weights, and an infant mortality rate of 7.5 per 1,000 births.
On the upside, North Carolina has a high immunization rate for children and low incidence of binge drinking.
The foundation also noted that in the past 5 years, two other indicators of poor public health significantly improved: North Carolinas air pollution decreased 34 percent and preventable hospitalizations came down 25 percent.
Staff writer John Murawski