Hawaii has been crowned the healthiest state in the US, a new report has found.

The Aloha State, earning the top spot five times in the last six years, earned high marks in the annual findings from the United Health Foundation for its low prevalence of obesity and smoking and low levels of air pollution.

Hawaii was followed by the same states that were in last year's top five: Massachusetts, Connecticut, Vermont and Utah.

Louisiana was named at the least healthy due to its high percentage of children in poverty and high of frequent mental distress and low birth weight.

The bottom five states all fell in the southern US: Mississippi, Alabama, Oklahoma and Arkansas.

The report also found that America's obesity rate has reached an all-time high, increasing five percent from the year before.

With one of three adults now classified as obese, the authors say as the obesity rate rises, so will the number of chronic illnesses and deaths due to heart disease.

Hawaii was named the healthiest US state while Louisiana was named at the least healthy, according to an annual report. Light blue indicates the healthiest states and dark blue indicates the least healthy states

TOP 10: THE HEALTHIEST STATES 1. Hawaii 2. Massachusetts 3. Connecticut 4. Vermont 5. Utah 6. New Hampshire 7. Minnesota 8. Colorado 9. Washington 10. New York Advertisement

BOTTOM 10: THE LEAST HEALTHY STATES 1. Louisiana 2. Mississippi 3. Alabama 4. Oklahoma 5. Arkansas 6. Kentucky 7. West Virginia 8. South Carolina 9. Tennessee 10. Indiana Advertisement

The annual ranking looked at 35 health markers including rates of smoking, obesity, immunization and number of physicians.

The bottom 10 states all had problems that have plagued rural America for several years.

Louisiana's challenges including a high prevalence of adult obesity at 36.2 percent, high prevalence of adult smoking at 23.1 percent, and a high percentage of low birth weight babies at 10.6 percent of live births.

However, the top 10 states were not without their woes.

In Hawaii, more than 21 percent of adults reported excessive compared with 19 percent nationally.

This is a consistent with a survey from the American Addiction Centers that looked at the binge-drinking patterns of veterans in all 50 states and found Hawaii to have the most amount of veteran binge-drinkers at 21.5 percent.

Additionally, about 11 percent of adults in the stated reported they have diabetes, compared with 10.5 percent at the national level.

Five states also improved by jumping at least three ranks, with Maine having the most success moving from No 23 to No 16 this year.

Meanwhile Oklahoma experienced the biggest drop in rank, falling from No 43 to N. 47.

The America's Health Ranking Annual Report also found that the nation's obesity rate reached the highest level ever this year from 29.9 percent to 31.3 percent.

The obesity rate rose five percent with one in three adults now experiencing obesity.

Obesity was found to be the highest amount adults between ages 45 to 64 at 35.6 percent and among rural adults at 34.8 percent.

There was also a disparity among races. Black adults were the most likely to be obese at 39 percent while Asian adults were the leazt likely at 11.2 percent.

The report showed that obesity rates increased as level of education decreased.

Adults without a high school degree had an obesity rate of 37.4 percent in comparison to 36.1 percent of adults with a high school degree, 34.8 percent of adults with some college and 23.3 percent of college graduates.

Data released from the Centers for Disease Control and Prevention earlier this year showed all of states in the 'bottom five' have more than one-third of adults who are dangerously overweight.

Obesity is known as a risk factor for several chronic health conditions including type 2 diabetes, strokes, heart attack and even certain types of cancer.

The report showed that obesity rates increased as level of education decreased. Adults without a high school degree had an obesity rate of 37.4 percent

Health officials say that addressing the obesity epidemic will not only lead to better health outcomes but also reduce medical costs.

In 2012, a study from Cornell University in New York found obesity accounts for about 21 percent of total US health care costs, approximately $190.2 billion per year.

Experts have warned that that proportion of obese American adults will only grow as younger generations do.

'This year's Annual Report spotlights an obesity problem that continues to grow. This means more people will likely develop obesity-related chronic diseases like cardiovascular disease, diabetes and cancer,' said Dr Rhonda Randall, chief medical officer of UnitedHealthcare National Markets.

'We encourage health professionals, public health officials and elected leaders to use these findings to explore opportunities to better support people in their communities in all aspects of their health.'

However, the report did find a few bright spots such as the reduced rate of childhood poverty.

A key indicator of socioeconomic status and overall health, childhood poverty fell six percent from 2017 to 18.4 percent in 2018.

But this decrease had a wide variation geographically. Louisiana's rate of 28 percent was about three times higher than New Hampshire, which had the lowest rate at 10.3 percent.

Additionally, the number of mental health providers per 100,000 people rose eight percent the number of primary care physicians increased five percent.

Massachusetts was named the state with the most mental health providers per 100,000 people, six times more than Alabama, the state with the fewest.

Similarly, Rhode Island had the greatest number of primary care physicians per 100,000 people, which was three time more than Idaho, the state with the lowest concentration.