Hawaii is the healthiest state in the nation, while Mississippi brings up the rear, according to the 2013 America’s Health Rankings released today.

The 50th state has consistently ranked near the top in the long-running index issued by United Health Foundation, which provides a comprehensive look at the well-being of each state. Hawaii placed second last year and third the year before.

"Hawaii’s No. 1 ranking is encouraging and reminds us how fortunate we are to live in the Aloha State," state Health Director Loretta Fuddy said. "I really think it’s a testament to the support that we do have from Gov. Abercrombie and the Legislature in helping us build back services. No one receives these awards by themselves. All of what we do is in partnership with the private sector."

Hawaii’s top billing rests on a range of measures, including lifestyle and policy choices, as well as the natural gifts of living in the islands. The report compiles 27 data points reflecting behavior, health status, medical care, policy, the community and environment.

Relatively low rates of smoking and obesity in the islands and high rates of health coverage and childhood immunization helped lift Hawaii to the top of the list.

"To be No. 1 you have to score well in most of the measures," said Dr. Ron Fujimoto, chief medical officer of UnitedHealthcare’s Community Plan for Hawaii. "One of the things that really shines is that Hawaii has a very low uninsured rate."

State law has long required employers to provide health insurance to employees who work 20 or more hours a week. The government also offers coverage through Med-Quest and the state child health insurance programs.

"We do very well for the population that’s economically challenged," Fuddy said.

As a result, more people have access to preventive care before health problems escalate. Hawaii had the lowest rate of preventable hospitalization in the country as well as the highest rate of childhood immunization. Deaths from cancer and cardiovascular disease were among the lowest in the nation.

With year-round balmy weather, Hawaii residents are more active than their mainland counterparts, boosting their health. Just 18.7 percent reported doing no exercise outside of their jobs in the past 30 days, compared with 22.9 percent nationally who were physically inactive.

While obesity rates are high everywhere in the United States, fewer adults in Hawaii — 23.6 percent — tip the scales as obese, compared with 27.6 percent nationally. Diabetes is less prevalent in Hawaii as well, but the averages mask wide disparities among different groups.

"Some ethnic groups experience significantly worse health than the average," Fuddy said. "We need to pay attention to the areas and populations that aren’t enjoying good health status."

Policymakers have been targeting smoking, and Hawaii now has the third-lowest rate of adults who smoke in the country. The smoking rate fell to 14.6 percent in the islands, down 2 points from the previous year, according to the report. That’s well below the current national rate of 19.6 percent.

"We are very pleased with the success we’ve had in reducing smoking, especially among adolescents," Fuddy said. "We’ve had great success with our quit line."

On the other side of the coin, Hawaii received poor marks for the prevalence of binge drinking and low high school graduation rate. The Health Department is especially concerned about drinking among pregnant women and is trying to get the message out about the danger it poses to infants. The state’s high school graduation rate is also below the national average, a health concern because dropouts tend to have poor health outcomes, she said.

The 50th state also had a relatively high incidence of salmonella infections, which could be connected to the popularity of picnicking here.

"The food tends to not be in the ideal temperature control at picnics," Fujimoto said. "That might account for some of the salmonella that we’re seeing."

Hawaii has placed first in the country on the health rankings four times in the past 15 years, Fujimoto said. It has never fallen below sixth place in the 24 years that the ratings have been produced.

Vermont, which came in first last year, is ranked second this year, followed by Minnesota. The three least healthy states are Louisiana, Arkansas and Mississippi.

The rankings are sponsored by the United Health Foundation in partnership with American Public Health Association and Partnership for Prevention. The index’s goal is to stimulate action to improve health across the country.

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On the Net:

» For full details, visit www.americashealthrankings.org.