LITTLE ROCK — Arkansas ranked 48th among the states in overall health this year, due in part to pervasive binge smoking, obesity and sedentary lifestyle, according to results of a national health study release Tuesday.

Vermont is the healthiest state for the sixth straight year, while Louisiana and Mississippi tied for last, according to the United Health Foundation’s "Americas’s Health Rankings" report.

Nationwide, nearly 28 percent of Americans are obese and more than 26 percent do not exercise, resulting in increasing prevalence of diabetes and high blood pressure, the report said.

Arkansas’ 2012 ranking was down a notch. The state ranked 47th in 2011.

The report complimented the state for its low prevalence of binge drinking, and for moderate per capita public health funding and immunization coverage. But it received low marks for its prevalence of smoking and obesity, as well as its high percentage of children in poverty.

Dr. Joe Thompson, the state surgeon general, said the report was a "pretty good reflection" of health conditions in the state where too many people go without preventive care because they lack health coverage.

"We end up just living in the basement, and I’m tired of it, " Thompson said. "I don’t see how we can possibly move out of the basement when 25 per cent of our working-age adults have no health insurance."

He advocated a proposed expansion of Medicaid to cover up to 250,000 of the state’s working poor, as well as Beebe administration efforts to overhaul the state’s system for paying health care providers. Gov. Mike Beebe wants the state to move from a system of paying providers for each service they provide to paying them for episodes of care.

"This is not just a health issue. This is one of the things we’ve got to get around for businesses to move here. We’ve got to move these numbers up," Thompson said.

Thompson said Arkansans also have to take personal responsibility for their health and get their blood pressure checked, quit using tobacco and be more active.

Overall, the report said medical advances are enabling Americans to live longer but that unhealthy behavior and preventable illness threaten quality of life.

It noted that while cardiovascular deaths have declined by more than 34 percent and cancer deaths by nearly 8 percent since 1990, "Americans are experiencing troubling levels of obesity (27.8 percent of the adult population), diabetes (9.5 percent of the adult population), high blood pressure (30.8 percent of the adult population) and sedentary behavior (26.2 percent of the adult population)."