As 2018 draws to a close, many of us are looking ahead thinking of what could be and making resolutions. But before you vow to get into shape or stress out less, know that where you live may be working against you. Louisiana, for example, is the least healthy state in America, and it has been in the bottom five before.

Compiled by the United Health Foundation, America’s Health Rankings report found that those living in the Pelican State face the greatest health challenges: 28 percent of all children live in poverty, 23 percent of all Louisianan smoke and 36 percent are obese. Rates of mental illness/distress are also higher — 4 percent higher than the national average.

Other low-ranking states — like Arkansas, Oklahoma, Alabama and Mississippi — faced similar challenges, while the healthiest states — which included Hawaii, Massachusetts, Connecticut, Vermont and Utah — tended to have a lower physician-to-patient ratio and less air pollution.

A total of 35 measures were used to calculate a states’ health ranking, including the aforementioned obesity rates, graduation rates, death and mortality rates and incidences of cancer or cardiovascular disease. And Dr. Rhonda Randall, chief medical officer of UnitedHealthcare National Markets and a senior adviser to the America’s Health Rankings report, told CNN, “[A] rank means that you overall are healthier than the states below you in the rank and are overall less healthy than the states above you in the rank.”

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