Minnesota is the healthiest state for older adults, and Mississippi is the least healthy, according to a new report from the United Health Foundation.

The 2017 America’s Health Rankings Senior Report ranks each state across 26 measures of health determinants and eight measures of health outcomes.

According to the report, some of Minnesota’s strengths are that it has a high percentage of volunteerism, a low percentage of intensive care unit use and a low prevalence of frequent mental distress. Among its challenges, authors said, are that it has a high percentage of low-care nursing home residents, a low prevalence of seniors who have a dedicated healthcare provider and a high prevalence of excessive drinking.

The healthiest states for seniors are spread throughout the United States. Rounding out the top five states on this year’s list: Utah (second), Hawaii (third), Colorado (fourth) and New Hampshire (fifth).

The least-healthy states are clustered in the South, according to the foundation. In addition to Mississippi, other states at the bottom of the list include Kentucky (49), Oklahoma (48), Louisiana (47) and Arkansas (46).

According to the report, some of Mississippi’s strengths are that it has a low prevalence of excessive drinking, a high percentage of home-delivered meals and a high prevalence of pain management. Among its challenges are a high prevalence of physical inactivity, a high percentage of seniors living in poverty and a low prevalence of high health status.

California showed the greatest improvement in rank in one year, the authors said; the state jumped 12 spots, from 28 to 16. South Dakota improved 10 spots, from 25 to 15. Pennsylvania and Alaska, on the other hand, dropped eight spots each and now rank 26 and 29, respectively.