(CNN) -- Despite years of efforts to even out health disparities across the United States, some states are dramatically healthier than others, according to a new report.
Massachusetts, Hawaii, Vermont, Utah and Connecticut rank as the five healthiest states, while West Virginia, Alabama, Arkansas, Louisiana and Mississippi rank the least healthy in America's Health Rankings, according to the report by the United Health Foundation.
Illinois falls in at number 27, while Iowa ranks at number 15. Iowa fell in at number 7, however, when it comes to health outcomes, which the report defines as behaviors, policy, community & environment, and clinical care combined.
The rankings take into account a variety of health factors, such as rates of infectious diseases, obesity, physical inactivity, smoking and infant mortality, as well as air pollution levels and the availability of health care providers.
This is the first time Massachusetts has been named the healthiest state, ending Hawaii's five-year reign.
The Bay State won the honor in part due to having the lowest percentage of uninsured residents at just 2.7% of the population, plus a low prevalence of obesity and a high number of mental health providers.
Mississippi and Louisiana, ranked 49th and 50th, have major health challenges, according to the report, including a high prevalence of smoking, obesity and children in poverty.
The report, America's Health Rankings, has been analyzing state health standings for 28 years.
Across the country, health disparities have been noticed not just between states, but even within the same metropolitan area.
For example, neighborhoods just 12 miles apart in the Washington area, have a nine-year difference in life expectancy, according to the Robert Wood Johnson Foundation.
These "shocking differences in life expectancy" are based on geography, income, education and race, according to the American Public Health Association.
"This is unacceptable. We believe health is a basic human right. It's a right for all people and all communities," according to a statement on the association's website.
Overall, the nation's health is not improving; in fact, it's getting worse.
The nation's premature death rate -- the number of years of potential life lost before age 75 -- increased for the third straight year. That rate has gone up 3% since 2015, with cardiovascular deaths in particular having gone up 2% in the same time period.
Drug-related deaths have increased 7% in the past year, and even states with high health rankings overall have faced an uphill battle in this area.
According to the new report, three northeastern states that rank toward the top in overall health have experienced large increases in drug deaths. New Hampshire's rate increased by 118%, Massachusetts' rate increased by 69%, and Rhode Island's increased by 56%.