The news may come as no surprise: Ohio isn't an epicenter for healthy living.

America's Health Rankings places Ohio 40th out of 50 states for the second year in a row. And, there are familiar themes: infant mortality, smoking, and obesity are major factors in the state's low rank.

But, as Dr. Reed Tuckson of the United Health Foundation, points out, this wasn't always the case.

"Ohio orginally was 27th in the country in overall healthiness, so things are not moving in the right direction," Tuckson says.

Tuckson says to make the number move in the RIGHT direction, people need to stop smoking, start taking walks and parents need to make sure their kids get vaccinated. The state ranks 48th in the country for immunizations.

"We're failing our children when this happens. So let's protect our children," Tuckson says.

The report is sponsored by several groups including United Health Foundation and the American Public Health Association.