Indiana ranked 41st in a state health survey released Thursday, a position unchanged from a year earlier.
The major reasons the state finished in the bottom 20 percent of the country for health? Its high incidence of smoking, high levels of air pollution and lack of spending on public health, according to the study conducted by the United Health Foundation.
"Even though (the ranking is) unchanged from last year, we have had several victories," noted Dr. Julie Daftari, medical director for UnitedHealthcare of Indiana.
"Hoosiers were more active than they were the year before. There was a steady decline in the number of people with diabetes."
The state's strengths included its high rate of high school graduation, low incidence of salmonella infection and large number of adolescents who received the meningococcal vaccine.
"Despite those improvements, we have had an increase in the smoking rate," Daftari added. "We do continue to face challenges."
Other notable statistics in the report include an increase in child poverty over the past year, decrease in the infant mortality rate over the past two years and a drop in the number of preventable hospitalizations among Medicare beneficiaries over the past five.
"I think it's important we increase the awareness of the health challenges our communities face," Daftari said. "I hope Hoosiers use the information in the report to make more informed health decisions."