(NEXSTAR) — A new study has identified the region with the unhealthiest population in America.

Forbes Advisor conducted the analysis and ranked each state based on several factors, including rates of drug abuse, unhealthy lifestyle habits, and chronic disease.

According to the Centers for Disease Control and Prevention, chronic diseases are health conditions that last a year or longer and require ongoing medical treatment.

The CDC notes that these illnesses – such as heart disease, cancer, and diabetes – are the nation’s leading causes of death and disability.

A 2023 report by The Commonwealth Fund, an independent research group, also found that the U.S. has the highest rate of people diagnosed with multiple chronic illnesses when compared to other wealthy nations.  

As for the unhealthiest state in America, West Virginia claims the No. 1 spot. The Mountain State, considered ground-zero for America’s opioid crisis, stands out with the highest drug overdose death rate in the U.S., according to the Forbes Advisor analysis. Lately, the use of fentanyl and the so-called “zombie drug” xylazine has fueled the state’s epidemic, NewsNation reported.

West Virginia also has the highest percentage of adults who smoke (21%), the highest percentage of adults who are obese (41%), and the second shortest life expectancy nationwide (73.9 years).

Mississippi, deemed the second unhealthiest state, has the shortest life expectancy at 73.63 years, the study found. The Magnolia State faces elevated rates of chronic diseases, including the highest cancer mortality rate in the country (17.37 deaths per 100,000 state residents).

The data also shows that Mississippi has higher rates of diabetes and hypertension, with 43.9% of adults in the state diagnosed with high blood pressure and 13.7% diagnosed with diabetes.

Aside from West Virginia and Mississippi, six other southern states are among the top 10 unhealthiest:

1. West Virginia
2. Mississippi
3. Tennessee
4. Arkansas
5. Kentucky
6. Alabama
7. Louisiana
8. Oklahoma
9. Ohio
10. Indiana

Hawaii, one of the most beautiful states in the U.S., has the best health profile. The Forbes Advisor study found that residents in the Aloha State have the highest life expectancy in the country (80.87 years), and the prevalence of chronic diseases is notably lower compared to other states.

Minnesota is the only Midwest state listed among the top 10 healthiest. Five East Coast states also made the list, while the others are scattered across the West:

1. Hawaii
2. Utah
3. Connecticut
4. Minnesota
5. Massachusetts
6. Colorado
7. New Jersey
8. New Hampshire
9. Washington
10. New York

For its analysis, which you can view in full here, Forbes Advisor analyzed data from the CDC, the Kaiser Family Foundation and the Substance Abuse and Mental Health Services Administration.