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RALEIGH The 2016 America’s Health Rankings Annual Report released by United Health Foundation said N.C. is just below middle of the pack in healthy lifestyles and health outcomes. Hawaii ranked the healthiest while Mississippi ranked the least healthy of all the states.The annual report ranks each state across 34 measures of behaviors, community and environment, policy, clinical care, and outcomes. The report found that smoking has dropped by 41 percent nationally, and preventable hospitalizations have decreased 34 percent, while immunizations have risen. However, the obesity rate in the U.S. and N.C. is on the rise with nearly 30 percent of North Carolinians falling into the obesity range.”We are down a spot from 2015, so as we look for some challenges and how to improve, on the positive side, some things we do well the level of immunization for kids are high and our excessive drinking is low. But obesity is a real challenge for us,” said Garland “Scottie” Scott, the CEO of UnitedHealthcare for North and South Carolina and Georgia.North Carolina is not alone. The rate of obesity nationally has increased by 157 percent nationwide since 1990. Obesity increased across all education groups, but the average rate of change per year was two-and-a-half times higher among high school graduates than college graduates. For the first time in the report’s 27-year history, the rate of cardiovascular death has increased after decades of steadily dropping.The report also finds that in the past five years, the rate of drug deaths has increased by 9 percent, rising 4 percent just since 2015. According to the report, drug overdoses are now the leading cause of injury deaths in the U.S. with more than six out of 10 drug deaths involving an opioid, primarily prescription pain relievers, or heroin. Opioid-related overdose deaths increased 200 percent between 2000 and 2014. The total cost of illicit drug use on the U.S. economy including its impact on crime, health, and productivity is an estimated $193 billion per year.UnitedHealthcare says that the Health Rankings Annual Report is meant to provide a benchmark for states to plan for the future.”We want this report to be a catalyst around data-driven discussions about improving health and driving positive change,” said Scott. “We can help local and state leaders and business leaders make better decisions on behalf of the population that they are serving and working with.”UnitedHealthcare also anticipates that with growth in technology they’ll see growth in consumers taking more control over their health. Their new program, called “Rally,” is a mobile app and website that rewards users with “coins” for setting and meeting their health goals.”It provides virtual visit access and mobile tracking for wellness goals,” said Scott. “More and more consumers engaging and managing their own health is a big part of the solution. We are working to enable them with the tools and technology for access to care and for measuring their performance from a wellness perspective.”According to the report, Massachusetts, Connecticut, Minnesota, and Vermont ranked as the second through fifth healthiest, while Louisiana, Arkansas, Alabama and Oklahoma joined Mississippi at the bottom of the list.