Clean air and high graduation rates weren't enough to boost Wisconsin’s score this year in United Health Foundation’s annual health rankings.

The state’s prevalence of excessive drinking and low per capita spending on public health programs ranked Wisconsin 23rd in the nation for health.

Wisconsin ranks as the worst state in the country this year for excessive drinking, with about 24 percent of adults reportedly drinking to excess. By comparison, the No. 1-ranked state for the least amount of excessive drinking, which is Utah, reported about 12 percent of adults drink to excess.

From a monetary perspective, in Wisconsin, $52 is spent per person on public health funding, compared to $281 spent per person in Alaska, which spends the most on public health. Because of this, Wisconsin is ranked 47th in this category.

This is the 29th year the United Health Foundation has put together its health report. The report is the longest-running annual assessment of the nation’s health on a state-by-state basis.

It uses 35 markers of health to determine outcomes. This year, the report found increases in mortality and chronic disease, such as obesity, are continuing to have an effect on the nation’s health.

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Dr. Rhonda Randall with UnitedHealth Group echoes the reports concerns about obesity, saying now one in three people in the United States are considered obese.

"Obesity is a contributor to many chronic diseases including cardiovascular disease, diabetes and cancer," Randall said. "So even more concerning than the prevalence is that obesity puts people at greater risk for other diseases."

Wisconsin ranks 30th in the country for obesity.

In Wisconsin, there have been positive and negative changes in the state:

In the past six years, obesity increased 16 percent to 32 percent of adults

In the past three years, air pollution decreased 25 percent

In the past three years, chlamydia increased 13 percent to 466 cases per 100,000 population

In the past year, HPV immunization among males aged 13 to 17 increased 29 percent to 48.8 percent

In the past three years, children in poverty decreased 21 percent to 14.5 percent of children aged 0 to 17

In the past year, premature death increased 6 percent

Last year, Wisconsin was ranked 21st in the overall health ranking. This year, the state ranks 10th for senior health and 15th for the health of women and children.

Hawaii, Massachusetts and Connecticut are the top three healthiest states. Alabama, Mississippi and Louisiana ranked last.