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A landmark study has determined the unhealthiest place to live in America – and its bad news for millions of people living in the South.  

By combining 21 metrics including percentage of adults who smoke, obesity rates and cancer mortality, Forbes Advisor found that West Virginia is the worst state in America for staying in shape. 

One in five people in the Mountain State are smokers, with it also ranking first in diabetes mortality and second in shortest life expectancy, at just 73.9 years. 

Mississippi, Tennessee and Arkansas helped the South emerge as the least healthy region in the US, while Hawaii residents blew the competition out of the water as the island came out on top.

The South owns eight of the 10 unhealthiest states in America, through a combination of rampant substance abuse, poor health and lifestyle choices, and a high risk of disease

The South owns eight of the 10 unhealthiest states in America, through a combination of rampant substance abuse, poor health and lifestyle choices, and a high risk of disease 

Five of the 10 healthiest states in America are found on the East Coast - but Hawaii came out on top thanks to its long life expectancy and exercise-obsessed residents

Five of the 10 healthiest states in America are found on the East Coast – but Hawaii came out on top thanks to its long life expectancy and exercise-obsessed residents 

For West Virginia to rank as the unhealthiest in America, residents took up some of the worst habits available to them.  

The state has the highest percentage of obese adults in America at 41 percent, the same percentage of adults with high cholesterol, while it also owns the highest diabetes mortality rate at a shocking 41.7 percent. 

West Virginia has the highest drug overdose death rate at 75.03 per 100,000 people, over 50 percent higher than the next worst state Delaware, at a time when officials have struggled to stop the drug ‘tranq’ flooding the state. 

The state also recently came in last among the most diverse states in America.  

Of the top 10 states with the unhealthiest populations, eight are found in the South, with Tennessee, Arkansas, Kentucky, Alabama, and Louisiana residents also ranking poorly. 

Mississippi is the state closest to West Virginia, however, particularly due to its issues with disease and healthcare services. 

The state is first is cancer mortality at 178.97 deaths per 100,000 residents, while also owning the highest mortality rates in hypertension, kidney disease, and strokes. 

It also has the shortest life expectancy in the nation at 73.63 years, and adults in the state were the most likely to say they hadn’t exercised in the past month at 31.9 percent. 

Tennessee, Arkansas and Kentucky round out the top five, with Oklahoma, Ohio and Indiana also ranking in the top 10 unhealthiest states in the nation.  

West Virginia (pictured) is the unhealthiest state in America. One in five people in the Mountain State are smokers, with it also ranking first in diabetes mortality and second in shortest life expectancy, at just 73.9 years

West Virginia (pictured) is the unhealthiest state in America. One in five people in the Mountain State are smokers, with it also ranking first in diabetes mortality and second in shortest life expectancy, at just 73.9 years 

Hawaii residents' obsession with health has seen the Aloha State rank first in America's healthiest states, coming out on top in in life expectancy at 80.87 years, second lowest in obesity at 25.9 percent, and fifth and sixth lowest in drug and cigarette use, respectively

Hawaii residents’ obsession with health has seen the Aloha State rank first in America’s healthiest states, coming out on top in in life expectancy at 80.87 years, second lowest in obesity at 25.9 percent, and fifth and sixth lowest in drug and cigarette use, respectively

Experts warn that America is becoming increasingly less healthy. From 2025 to 2060, the number of Americans suffering from diabetes is expected to rise by 39.3 percent, hypertension by 27.2 percent, and obesity by 18.3 percent

Experts warn that America is becoming increasingly less healthy. From 2025 to 2060, the number of Americans suffering from diabetes is expected to rise by 39.3 percent, hypertension by 27.2 percent, and obesity by 18.3 percent

On the other end of the spectrum, Hawaii cruised to first place thanks to its residents’ love of exercise and aversion to drugs and smoking. 

The Aloha State ranks first in life expectancy, at 80.87 years, second lowest in obesity at 25.9 percent, and fifth and sixth lowest in drug and cigarette use, respectively. 

While many of the rest of the top 10 are found on the East Coast, Utah emerged as America’s second healthiest state. 

The highly religious state has the fourth lowest percentage of adults who are heavy drinkers at just five percent, the lowest percentage of smokers (6.7 percent), and the second lowest number of adults who failed to exercise in the last month (16.9 percent). 

The state’s residents also performed well in a number of health statistics, including the lowest cancer mortality rate, second lowest blood pressure rate, and fourth lowest levels of high cholesterol. 

After Utah, rounding out the top five healthiest states are Connecticut, Minnesota and Massachusetts. 

In comprising its list, Forbes says it found that many Americans are becoming rapidly less healthy, with six in 10 adults now suffering from at least one chronic disease, according to the CDC. 

From 2025 to 2060, the number of Americans suffering from diabetes is expected to rise by 39.3 percent, hypertension by 27.2 percent, and obesity by 18.3 percent, according to the Journal of the American College of Cardiology. 

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This post first appeared on Daily mail