CHARLESTON, W.Va. — Out of all 50 states, West Virginia ranked 47th on this year’s United Health Foundation’s America’s Health Rankings released Thursday.

The annual report reveals state-by-state health trends by looking at areas such as the rising rates of drug deaths, obesity, diabetes and children in poverty among American citizens.

The 26th edition of the Rankings found that West Virginia is at the bottom of the list when it comes to the amount of drug related deaths.

“West Virginia is ranked 50th with drug deaths with 32.4 (percent). The best state in the nation is 2.7 as far as drug deaths per 100,000 (people), so that’s very concerning to us,” said Dr. Rhonda Randall with UHF.

Randall said lifestyle choices, such as drug use and obesity, is what is pulling West Virginia’s rank down.

Many federal, state and local health officials, as well as law enforcement, are continuing to tackle the state’s ongoing drug epidemic. Needle exchange programs have been introduced at several county health departments statewide this year. Better access to the drug Narcan, which reverses the effects of opiods when someone is experiencing a heroin overdose, has also been in place for officials and police officers who are now allowed to administer the drug.

West Virginia’s rank dropped three spots since last year. In 2014, the state was listed at the 44th spot, but this year it stands at 47th.

The report shows the Mountain State is ranked #1 in the nation for infectious diseases, but lacks immunization coverage.

Randall said the healthiest state this year is Hawaii. She said this because the residents living there are very active and that West Virginians can be too.

“I was in West Virginia not too long ago. You’ve got such a beautiful area where it’s really easy to take a walk where you have to walk up a nice rolling hill and down a nice rolling hill. That’s great exercise and it’s free,” she said.

Overall, the study found Americans are continuing to improve on smoking, which declined by 5 percent this year and sedentary behavior, which declined by 11 percent. However, in the past 2 years, obesity increased 7 percent from 27.6 percent to 29.6 percent of adults and diabetes continues to increase, now at 10 percent. The percentage of children living in poverty also increased 6 percent in the last year.