The annual report, now in its 22nd year, measures problems and progress in all 50 states in the U.S. – using data from the Centers for Disease Control and Prevention, Census Bureau and American Medical Association.

While the report concludes we’re living longer (life expectancy is now 78.5 years), the flip side is that we’re living sicker. ”What worries us in particular about this year’s report is that some key risk factors that are driving up preventable chronic illness are getting worse,” Dr. Reed Tuckson told CBSNews.com.

An incredible 26% of the country (1 in 4) in physically inactive – a sedentary lifestyle that can lead to such health problems as heart disease, diabetes and certain forms of cancers. The report also found some 66 million Americans to be obese – 27.8% of the country and rising.

“There’s no way that this country can possibly afford the medical care costs and consequences of these preventable chronic illnesses,” says Tuckson. “We have two freight trains headed directly into each other unless we take action now.”

“People have to be successful at taking accountability for their own health-related decisions.”

Vermont scored the top position for the sixth year in the row due to its high rate of high school graduation, low violent crime rate, low incidence of infectious disease, low prevalence of low birthweight infants, high per capita public health funding, a low rate of uninsured population, and ready availability of primary care physicians.

Coming in second was Hawaii – followed by New Hampshire, Massachusetts and Minnesota.

For the 22nd year in a row Mississippi and Louisiana scored near the bottom – with Miss. in particular reporting more than 800,000 adults living a sedentary lifestyle, 780,000 adults that are obese and almost 280,000 adults with diabetes.

Check out the full rankings here.

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