Updated

An annual report released Tuesday put Minnesota at the top of its health rankings for the fourth straight year, while concluding that the nation's health improved slightly.

The report by United Health Foundation, an independent, not-for-profit foundation funded by the health care company UnitedHealth Group, said Americans are 0.3 percent healthier than they were a year ago.

The report is based on factors such as personal behaviors, the environment people live and work in, decisions by public and elected officials, and the quality of medical care delivered by health professionals.

Examples include smoking, motor vehicle deaths, high school graduation rates, children in poverty, access to care and incidence of preventable disease.

Dr. Reed Tuckson, senior vice president of the United Health Foundation, called the report a "call to action for all of us" to make the nation healthier.

"We can do better and our children deserve better," he said.

Minnesota, which has held the top spot in 11 of the 17 years of the survey, was cited for, among other things, its low rate of uninsured (8.4 percent), low percentage of children in poverty (10 percent), and low infant mortality rate (5.1 deaths per 1,000 live births).

Vermont was second on the list, followed by New Hampshire, Hawaii and Connecticut. At the other end, the report listed Louisiana as the least-healthy state, followed by Mississippi, South Carolina, Tennessee and Arkansas.

The report also points out states that have made the most progress in overall health since last year, as well as those that have regressed the most. Illinois saw the biggest jump, followed by Ohio, Wisconsin and Kansas. New Mexico had the biggest drop, followed by Idaho and West Virginia.

Nationally, the level of growth in health as measured by the report has been nearly flat since 2000, averaging only 0.3 percent a year, compared to an average increase of 1.5 percent a year from 1990 to 2000.

The United Health Foundation said factors contributing to the slowed growth include tobacco use, infant mortality, and increasing obesity. The report also found that the percentage of uninsured Americans has increased from 13.4 percent in 1990 to 15.9 percent today.

The report was produced in partnership with the American Public Health Association and Partnership for Prevention.