By Sean Whaley, Nevada News Bureau

CARSON CITY — Nevada’s overall health improved five spots this year compared to the rest of the nation, but still ranks in the bottom 10, according to the 22nd edition of America’s Health Rankings.

Nevada’s health improved from 47th in 2010 to 42nd in the new report.

The good news: Nevada has a lower prevalence of obesity than other states, ranking fourth with 23.1 percent of the adult population identified as overweight.

Smoking has also decreased significantly in Nevada, from 29 percent to 21.3 percent of the adult population in the last 10 years.

But these positive developments mask just how serious these health issues continue to be, said Steven Evans, chief medical officer for UnitedHealthcare of Nevada.

While Nevada’s obesity rate may be lower when compared with other states, the reality is that in the past 10 years, obesity has increased from 17.9 percent to 23.1 percent of the adult population. There are now 470,000 obese adults in the state.

And while Nevada’s smoking rate has declined due in large part to voter approval of tough smoking restrictions in 2006, there are still 434,000 adults who smoke.

“Obesity has actually increased in the past 10 years,” Evans said. “So although we, compared to the rest of the country, have done better, there is still a significant portion of our population that is obese.

“We definitely have not turned the corner on that health issue and it has probably become our No. 1 health issue we need to start worrying about,” he said.

“I almost don’t even want to celebrate the fact that we are less obese than the rest of the United States because we still have significant issues with that,” Evans said.

The report was released earlier this month by the United Health Foundation in collaboration with the American Public Health Association and Partnership for Prevention.

“America’s health rankings from United Health Foundation is an incredibly valuable tool for us to clearly understand health trends facing us as a nation and here in Nevada,” Evans said. “By identifying the key opportunities we face as a state we can pursue innovative solutions to those opportunities.”

The report shows a few other positives for Nevada.

The state has a low incidence of infectious disease, ranking fourth with 4.8 cases per 100,000 of population. Nevada also has a low rate of preventable hospitalizations, ranking 15th at 58.6 per 1,000 Medicare enrollees.

But there is more bad news as well.

Nevada has a low high school graduation rate, ranking 50th with only 56.3 percent of incoming ninth graders graduating within four years. Evans said those with higher education levels tend to have access to health insurance and take better care of their health overall.

Nevada also has a high violent crime rate, again ranking 50th with 661 offenses per 100,000 population, and a low immunization rate, ranking 49th with 84.6 percent of children aged 19 to 35 months covered with the appropriate inoculations.

In the past year, the percentage of children in poverty increased from 17.9 percent to 23.6 percent of persons under age 18. And in the past five years, diabetes increased from 7.1 percent to 8.5 percent of the adult population. There are now 173,000 Nevada adults with diabetes.

The report shows that for the fifth year in a row, Vermont was the nation’s healthiest state. States that showed the most substantial improvement include New York and New Jersey, both moving up six places. Idaho and Alaska showed the most downward movement. Idaho dropped 10 spots, from number nine to 19 in this year’s rankings, and Alaska dropped five places.

It also shows that the nation’s overall health did not improve from 2010 to 2011 because gains in one area were offset by worsening conditions in another.

One example of this stagnation is improvements in the number of smokers being off-set by worsening rates of obesity. The rankings found that, for every person who quit smoking in 2011, another person became obese.