A comparison of state rakings from 2007 to 2008 released Wednesday by the United Health Foundation in collaboration with the American Public Health Association and the Partnership for Prevention places Vermont at the top of the list, while Louisiana is at the bottom of the list when it comes to their residents’ health. United Health Foundation is a nonprofit organization funded by one of the country’s largest insurance companies, UnitedHealth Group.

“America’s Health Rankings 2008” compared states on a variety of health measures to determine whether the nation’s health is getting better or worse. This year, the report rated states on 23 measures, including immunization rates, obesity, Infectious disease rates, air pollution, health insurance coverage, premature death and violent crime.

The report found that many southern states were clustered near the bottom of the rankings, which is not a surprise considering the reports from previous years. The region has some of the highest rates of obesity, which contributes to heart disease, stroke, diabetes, and some types of cancer, as well as high rates of smoking, which causes cancer, lung disease, heart disease and other problems. At the bottom of the list is Louisiana, which replaced Mississippi, named least healthy state last year. This year, Mississippi climbed a spot to No. 49, followed by South Carolina, Tennessee and Texas.

Louisiana is confronted with a high prevalence of obesity, a high percentage of children in poverty, a high rate in infant mortality, premature death and cancer deaths and a high rate of uninsured population. One in five Louisianians lacks health insurance while 31 percent are obese.

Oppositely, Vermont has been named the healthiest state for the second year in row. The prevalence of smoking declined to 17.6 percent of the population, there is a slower rise in obesity than the US national average, and the number of people without health insurance remains low, the report found. Also, Vermont has a low percentage of children in poverty, ready access to primary care for residents, a high rate of high school graduation and high immunization coverage.

“Vermont really proves the point that these problems are not insurmountable,” said Dr. Reed Tuckson, a board member of the United Health Foundation and the vice president and chief of medical affairs for the parent company UnitedHealth Group.

Vermont is followed in top 5 by Hawaii, New Hampshire, Minnesota and Utah. Minnesota slipped to No. 4 this year from No. 2 last year, after four consecutive years of ranking the healthiest state. Hawaii had similarly low obesity, the highest public health spending, little air pollution, low rates of uninsured people, a low rate of preventable hospitalizations and low rates of death from cancer and cardiovascular disease.

Overall, the report indicates 36 states had positive changes in their health scores and 14 experienced declines. States with the greatest overall health score improvement from 2007 are Arkansas, New Mexico and Kentucky. Texas and Montana have shown the least improvement in health over the last year.