Georgia and its southern neighbors continue to boast some of the worst rates of obesity, smoking and overall poor health in the country, a new study of health in the U.S. shows.

The Peach State ranked No. 38 for overall health this year, according to the annual report by the United Health Foundation, a Minnesota-based nonprofit. That’s an improvement from five years ago when Georgia ranked 43rd nationally. Mississippi had the worst overall health this year, followed by Arkansas and Louisiana.

Nationally, Americans’ health seems to be improving somewhat. Rates of smoking and physical inactivity dropped significantly, while the obesity rate remained relatively unchanged from last year, according to the study.

Hawaii topped the rankings as the healthiest state in the nation with particularly low rates of uninsured people, obesity, smoking and preventable hospitalization, the report shows.

Georgia ranks 30th in both obesity and smoking, as well as 28th in diabetes. More than 2.1 million adults in Georgia are considered obese. And more than 720,000 adults have diabetes.

On the plus side, Georgia has a relatively low prevalence of binge drinking and has high rates of immunization coverage among kids.

Learn more about Georgia’s ranking and how it compares to other states at www.americashealthrankings.org.

Top five healthiest states

1 – Hawaii

2 – Vermont

3 – Minnesota

4 – Massachusetts

5 – New Hampshire

Five least healthy states

50 – Mississippi

49 – Arkansas

48 – Louisiana

47 – Alabama

46 – West Virginia

Source: America’s Health Rankings, United Health Foundation