North Carolina’s overall health rankings slipped to thirty-third from thirty-second this year, according to the United Health Foundation study America’s Health Rankings.”

According to a press release, compilers of this report have combed through data annually for twenty-eight years on “behaviors, community and environment, policy, clinical care, and outcomes” to present an overall view of the nation’s health as well as state-by-state rankings.

In one disturbing finding, premature deaths in North Carolina are up for the second year in a row.

“Looking closely at mortality measures in the state, since 2012 drug deaths increased 14% from 12.3 to 14.0 deaths per 100,000 population, while the rates of cardiovascular deaths and cancer deaths each remained relatively steady,” the study says.

What factors are at work here? Two pop out: 10.8 percent of the population is uninsured. That’s more than a million people, and it puts North Carolina at No. 41 in that ranking.

In addition, there’s public health funding of $56 per person, landing us at No. 42.

And the infant mortality rate of 7.2 per one thousand live births means North Carolina ranks forty-second in the category.

Bright spots? We’re No. 6 in childhood immunizations. And tenth from the top in deaths on the job, plus twelfth in not drinking too much.

But at disparities in health status, measured by the percentage difference based on high school education, North Carolina ranks tenth from the bottom.

Compared to most of the rest of the South, home to all the ten bottom states, we’re not bad at No. 33. (OK, Virginia is nineteenth.)

The study does not get into political orientation, but as a matter of information, every one of the bottom ten states went red in the 2016 presidential election. Of the top ten healthiest states, nine were blue, and Utah was red.

In one more comparison, four out of the bottom ten expanded Medicaid coverage under the Affordable Care Act. Of the top ten, nine expanded Medicaid, and Utah did not.

Top 10

1. Massachusetts

2. Hawaii

3. Vermont

4. Utah

5. Connecticut

6. Minnesota

7. Colorado

8. New Hampshire

9. Washington

10. New York

Bottom 10

41. Georgia

42 Kentucky

43. Oklahoma

44. South Carolina

45. Tennessee

46. West Virginia

47. Alabama

48. Arkansas

49. Louisiana

50. Mississippi