The 10 Healthiest and 10 Least-Healthy States in 2014

— -- intro:In some ways, Americans today are healthier than they were in 1990, when the United Health Foundation first published America's Health Rankings, an annual state-by-state assessment of our nation's health. Cardiovascular and cancer deaths are down, and the smoking rate has decreased 36%. Plus, life expectancy is at an all-time high—78.7 years.

"But although we're living longer, we're also living sicker, with preventable illness at an alarming level," says Reed Tuckson, MD, external senior medical advisor to United Health Foundation.

The number-one reason: Obesity.

"Since 1990, the obesity rate went from 11.6% to 29.4%, a 153% increase," Dr. Tuckson says. In the last year alone, it rose 7%. Physical inactivity is also at a new high: 23.5% of Americans do not exercise at all.

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Read on for the states that are doing it right—and the 10 that have a lot more work to do to improve their health.

quicklist: 1category: Health Benefits of Cinnamontitle: 10. Nebraskaurl:text: Change: +1

Nebraska is among the healthiest states in America in 2014, coming in at number 10 (a slight increase over last year). Nebraska has a low rate of drug deaths, high rate of high school graduation, and high immunization coverage among children.

Challenges: High prevalence of binge drinkingHigh incidence of SalmonellaLarge disparity in health status by education level

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quicklist: 2category: Health Benefits of Cinnamontitle: 9. North Dakotaurl:text: Change: None

North Dakota is the ninth most-healthy state in the U.S. this year, thanks to its low rate of drug deaths, high immunization coverage among teens, and low prevalence of low birth weight. North Dakota also came in ninth in 2013.

Challenges: High prevalence of binge drinkingHigh prevalence of obesityHigh occupational fatalities rate

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quicklist: 3category: Health Benefits of Cinnamontitle: 8. Coloradourl:text: Change: None

Colorado is known for its outdoor activities—hiking, skiing, biking—so it should come as no surprise that the state has the lowest rates for obesity and diabetes in the United States. It ranks eighth for the second year in a row.

Challenges: High prevalence of binge drinkingHigh prevalence of low birth weightLarge disparity in health status by education level

quicklist: 4category: Health Benefits of Cinnamontitle: 7. New Hampshireurl:text: Change: -2

New Hampshire comes in at number seven, and is just one of several New England states to rank in the top 10 for 2014. New Hampshire residents are more active than most Americans, enjoy a low rate of infectious disease, and have a low infant mortality rate. There is also high immunization coverage among teens.

Challenges: High prevalence of binge drinkingHigh rate of drug deathsLow per capita public health funding

quicklist: 5category: Health Benefits of Cinnamontitle: 6. Minnesotaurl:text: Change: -3

Minnesota is known for its bitterly cold winters, but that doesn't stop residents of this snowy state from keeping active, which also helps the state have one of the lowest obesity and diabetes rates in the nation. Minnesota also has a low rate of drug deaths.

Challenges:High prevalence of binge drinking High incidence of pertussisLow per capita health funding