Kentuckians are among the least healthy people in the country.

Kentucky ranked 45th for overall health outcomes — down three spots from 2017, according to an annual report from America’s Health Rankings.

The states that rank worse than Kentucky are Louisiana, Mississippi, Alabama, Oklahoma and Arkansas.

The top ranked states were Hawaii, Massachusetts, Connecticut, Vermont and Utah, respectively.

In the report, 35 markers of health associated with behavior, community and environment, as well as policy and clinical care are measured and ranked.

The report found Kentucky leads the nation in physical inactivity among adults, preventable hospitalizations and cancer deaths.

Additionally, Kentucky ranks 47th for rates of drug-related deaths, 49th for rates of smoking, 43rd for children in poverty and rate of obesity, 48th for frequent mental distress, 49th for frequent physical distress and 47th for premature death.

Some key positive highlights from the report included:

— In the past five years, the percentage of uninsured decreased 65 percent from 15.0 percent to 5.3 percent of the population, ranking Kentucky eighth in the nation.

— In the past 10 years, air pollution decreased 41 percent from 13.8 to 8.2 micrograms of fine particles per cubic meter

— Kentucky has low rates of violent crime, ranking fifth in the nation for rates of such crimes

— Kentucky ranks seventh for high school graduation rates, with  88.6 percent of people graduating.

Some key negative highlights from the report included: 

— In the past two years, frequent mental distress increased 17 percent from 13.8 percent to 16.2 percent of adults.

— In the past four years, diabetes increased 22 percent from 10.6 percent to 12.9 percent of adults

— In the past three years, excessive drinking increased 27 percent from 13.6 percent to 17.3 percent of adults.

— The rate is children living in poverty is 22.4 percent, ranking Kentucky 43rd in the nation.

— Since 1990, cancer deaths increased 11 percent from 211.6 to 234.9 deaths per 100,000 population.

The full report can be accessed at americashealthrankings.org.

State legislators and health officials should develop and implement policies with these figures in mind.

One critical aspect of improving the state’s health will be ensuring residents maintain access to health insurance, which will continue to improve access to care. Kentucky has made great strides in recent years in this area, evidenced by this report.

Without access to health care, Kentuckians will continue to fall behind the rest of the country in areas of health and wellbeing.

The health of the state’s residents is critical to our success in many ways. A healthy population means a healthier workforce, which can attract more businesses and industries to our state. Healthier children will be able to take better advantage of education opportunities. Improved health will reduce medical costs for the individual and the state.

Improving our state’s health rankings will not be an easy task. The state will need continue taking a multi-faceted approach to fighting the drug epidemic, working with public health agencies, hospitals, schools, law enforcement, churches and treatment programs.

We will also need to continue looking at policies and legislation that will reduce tobacco use.

It is past time to find ways to improve access to care for diabetics. Education about how to live with diabetes and prevent it will also be critical.

Likewise, improving access to mental health care and removing the stigma about mental illness with education campaigns will also be critical.

While we never like to see our state rank at the bottom of anything, it’s really not about the numbers.

Most importantly, we want to see our community and our neighbors healthier in all facets — physically, mentally, financially, etc.

Kentucky is a beautiful place to live and is full of potential. Our state can’t reach its greatest potential if its people are dying too early, suffering mentally and physically and falling behind in so many other ways.