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NORTH TEXAS (CBSDFW.COM) – When it comes to which state in the nation is healthiest, Texas falls at the lower half of the list. According to the America’s Health Rankings annual report the Lone Star State comes in 34th of the 50 states for overall health.

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While our state did well on lower smoking rates and is 3rd in the nation for high school graduates, the report, put out by the United Health Foundation, says Texans don’t do so well at the dinner table.

Dr. Rhonda Randall, the senior adviser to United Health Foundation, broke down some of the areas where Texas ranks near the bottom of the list. “Physical inactivity you’re ranked 43rd, obesity you’re ranked 40th, and with diabetes 34th.”

So exactly what illnesses are killing Texans most? Dr. Randall says, “Obesity comes first and diabetes follows, as well as cardiovascular deaths and cancer deaths.”

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Some of the low rankings might be attributed to the fact that the report shows Texas has the lowest number of insured, with more than 20 percent of residents paying out-of-pocket for 100 percent of their medical and surgical expenses.

The no. 34 ranking is down three spots from last year, when Texas came in at 31.

There is good and bad news across the country. Nationwide adult smoking rates continue to drop, down from 19 to 18.1 percent this year. Conversely, drug deaths in the U.S. have jumped 13.5 percent since 1990.

For the fourth year running, Hawaii came in as the nation’s healthiest state. This year Louisiana dropped below Mississippi to bottom out the list as the least-healthy state.

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