Indiana is done with 41.
After spending four years among the bottom 10 healthiest states in the U.S., Indiana has jumped two spots to No. 39, according to the United Health Foundation's America's Health Rankings annual report.
The report, released Thursday, analyzes data on a wide range of behaviors, community and environmental conditions, policy, clinical care, and outcomes. It is the longest-running annual assessment of the nation's health.
Indiana remained strong in a few areas and made progress in others. As in previous years, Indiana ranks high in high school graduation rates, immunizations and low incidences of salmonella.
The state's biggest improvement came in disparity in health status by education. That disparity decreased by 17 percent, from 27 percent to 22.4 percent, ranking Indiana seventh in the nation. It ranked 20th a year ago.
Indiana also showed improvement in obesity and smoking this year. The number of Indiana residents who smoke decreased by 2.3 percent, while the state's obesity rate declined by 1.4 percent. Indiana's obesity ranking rose from 44th to 36th, and smoking from 44th to 39th.
The state's No. 39 overall ranking suggests it still has a long way to go toward becoming healthier. Indiana needs to improve its infant mortality rate, fight back against a deadly drug crisis and increase public health funding, according to the report. Indiana is ranked 49th for public health funding. Combining state dollars dedicated to public health with federal dollars directed to Indiana, the Hoosier allocation is just $41 per person; the No. 1 state in that category, Alaska, has $261 per person.
In the past five years, drug deaths in Indiana have increased by 27 percent, from 13.1 to 16.7 deaths per 100,000 people. In the past year, the prevalence of diabetes increased 6.5 percent in Indiana while it decreased 13 percent nationwide. Diabetes is the nation's seventh-leading cause of death and contributes to other leading causes of death, including heart disease and stroke.
The report also showed a 2.9 percent rise in the rate of infant mortality in Indiana, dropping the state's rank from 36th in 2015 to 43rd in 2016. The top five causes of infant death are birth defects, preterm birth and low birth weight, maternal complications of pregnancy, sudden infant death syndrome, and injuries. These causes account for 57 percent of infant deaths.
Paul Halverson, founding dean of the IU Richard M. Fairbanks School of Public Health, said it's great to see positive changes in the rankings, but there is work to be done.
"We've made improvements in obesity and smoking, but we're still in the lowest third of both rankings," Halverson said. "Tobacco is the leading preventable cause of death in the United States. Also, we must do more to reduce the number of people with diabetes and improve infant mortality.
"One way to improve health in Indiana is to increase funding for public health," he said. "The health of the people is a critical element in our overall well-being and prosperity as a state. We're excited to see progress, but we need to redouble our efforts to diligently approach these important health indicators."
Indiana was the 41st-healthiest state in the U.S. from 2012 to 2015. That was the lowest ranking in the state's history. Indiana ranked 37th in 2011 and 38th in 2010.