Obesity and lack of health insurance is cited in a new report for a decline in the overall health of Nevadans.
The study by United Health Foundation ranks Nevada 39th in the country in overall health.
Last year, the state ranked 38th.
On the bright side, the report says Nevadans are smoking less.
In 2006, the annual report ranked Nevada eighth best in the nation in the category of obesity.
This year's study says the state's obesity rate has climbed to 25 percent of the population, dropping the state's ranking in that category to 24th.
Nevada's ranking for access to health insurance also dropped from 39th place last year to 44th place this year.
The biggest improvement was in smoking rates, where Nevada climbed to 36th, up from 39th last year.
Nevada ranked 49th in that category in 2000.