Tennessee's ranking for overall health got a boost — thanks in part to an improved obesity rate — up three places to No. 42 among the 50 states, according to a report released this week.

Although obesity rates in Tennessee are still above the national average, Tennessee's obesity rate dropped 6 percent in a year when the national obesity rate hit a record high, according to the United Health Foundation's annual America's Health Rankings. The 29th annual report used data on key factors that impact health ranging from behaviors — such as drug deaths and physical inactivity — to environment and medical care to see how states are doing relative to one another over time.

Hawaii was rated the healthiest state, followed by Massachusetts and Connecticut, while Louisiana was the least healthy state, followed by Mississippi and Alabama. Georgia ranked No. 39.

Dr. John Dreyzehner, commissioner of the Tennessee Department of Health, said he's pleased that Tennessee is improving and commended state and community initiatives to encourage more physical activity. However, high rates of cardiovascular deaths, cancer deaths and tobacco use are stifling further progress, he said.

"I continue to be deeply concerned about the number of people in Tennessee using tobacco and nicotine products ... that's one of our worst health behavior rankings," said Dreyzehner, who also served on the scientific advisory committee for the report.

He said programs have already helped lower smoking rates in pregnant women, and leaders have a "huge opportunity" to enact policy that prevents secondhand smoke exposure and drives down smoking rates, including raising the tobacco purchasing age to 21.

Other highlights for Tennessee were a low prevalence of excessive drinking, high immunization coverage among children and a high percentage of residents graduating high school.

Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets, said it's important for Tennessee to focus on improving its trouble spots, but also continue to do well in the successful areas.

"Children in the first three years of their life are getting their vaccines at a really high rate, preventing communicable diseases, and vaccines are one of the very best public health things that we can do," Randall said. "We know that if you achieve a high school graduation, diploma or greater than that, you're going to have better health throughout the course of your life."

She also said it takes time for the data to reflect positive changes.

"As obesity is coming down, if smoking is also coming down, it will take a little while until you see cancer deaths and cardiovascular deaths go down," she said, "but there is a very strong correlation between those behaviors and those outcomes."

The full report is available online at

Contact staff writer Elizabeth Fite at or 423-757-6673.