Kentucky is the 44th healthiest state in the U.S., according to a recent report analyzing the health of the nation.
The report, America's Health Rankings, attributes Kentucky's low marks to a high prevalence of smoking, a high rate of cancer deaths, and a high rate of preventable hospitalizations.
The report was produced by United Health Foundation, a nonprofit focused on the health and the well-being of communities.
Louisiana ranked 50th, followed by Mississippi, Arkansas and West Virginia. Hawaii topped the list as the healthiest state in the U.S. Indiana ranked 41st, down from 37th last year.
Kentucky ranked 47th last year.
Dr. Julie Daftari, Kentucky market medical director for United Healthcare, said the state's improvement on the list may be attributed to people making better lifestyle choices.
"Getting out and walking for 10 to 15 minutes over their lunch break or encouraging their neighborhood and family member to increase their activity and increase their overall health," she said.
Daftari said the challenges Kentuckians face may be related to the shortage of physicians in the state.
"Even though it looks like the communities in Kentucky have better access to health care coverage, it looks like there is still a shortage of primary care physicians in the state as a whole," she said. "Access to health care has some bearing on the overall outcomes of a population."
The report said in the past two years, lack of health insurance decreased by 24 percent in the state, from 15 percent uninsured to 11.4 percent.
Kentucky has drawn accolades for its implementation of the federal Affordable Care Act's provisions. Citing costs and other concerns, Kentucky's new governor, Matt Bevin, has vowed to roll back the state's Medicaid expansion and dismantle the state's health care exchange.
Just before leaving office this month, then-Gov. Steve Beshear issued a report touting improvements in the state's health standings.
The report also ranks Kentucky 49th for its smoking rate of 26.2 percent. Kentucky ranked 50th for cancer deaths.
"Smoking is actually directly related to numerous types of cancers. It's been linked to not only lung cancer but oral cancer, colon cancer, bladder cancer. So smoking does play a role in overall health," Daftari said.
The report lists Kentucky's strengths as having a low rate of violent crime, high rate of high school graduation, and a low rate of excessive drinking.
"I'm optimistic that the overall health rankings will improve. I think it's important that we all look to the future and do what we can to improve each other's health," Daftari said.