Washington ranks as the ninth healthiest state in the nation this year, leading the way for the Pacific Northwest, according to the annual “America’s Health Rankings” report from the United Health Foundation. To contribute to the high score, there was a noted low premature death rate, a low prevalence of physical inactivity and a low prevalence of low birthweights. However, some challenges remain for The Evergreen State, such as low Tdap immunization coverage among adolescents and a high incidence of pertussis.

For all states, rankings are based on four determinants that directly influence health outcomes: behaviors, community and environment, policy and clinical care. Washington scored five out of five stars in behaviors, clinical care and outcomes.

Washington ranks in the top three (of all states) for physical inactivity, occupational fatalities and low birth weight. Another area to watch that may single positive health changes for the state is the increased number of high school graduates throughout the past five years.

Topping the list as the healthiest states in the country this year are Hawaii (No. 1), Massachusetts (No.2) and Connecticut (No.3), while the states with the greatest opportunity for improvement are Louisiana (No.50), Mississippi (No. 49) and Alabama (No. 48).

For more information and the full report visit https://www.americashealthrankings.org/.