A long-running health report says the state of Utah is healthy compared to other states, but is trending downward.

Utah ranks No. 7 in the United Health Foundation’s ”America’s Health Rankings” for 2015, the longest-running annual assessment of the nation’s health on a state-by-state basis.

The report, which factors in a wide-ranging list of health determinants, says Utah ranks well because of its low rates of smoking, cancer deaths and diabetes. The Beehive state has the lowest smoking rate in the country, according to the report, and the eighth lowest violent crime rate.

Utah has finished in the top 10 every year since the report began in 1990 — and spent seven years in its No. 1 spot — but it hasn’t finished higher than No. 5 since 2010.

And despite the state’s overall high ranking, it has its share of health weaknesses.

For example, the report says Utah has the eighth-lowest rate of immunization coverage among adolescents. It was also fourth-worst in drug deaths and ranks below-average nationally in air pollution at No. 27.

The report also noted limited availability of primary care physicians as a weakness for the Beehive State.

Nationally, smoking has reached its third-lowest point in the report’s history, but obesity and diabetes continue to climb to new records each year.

Hawaii earned the top spot for the fourth-straight year, followed by Vermont and Massachusetts.

Louisiana came in last at No. 50. North Carolina improved the most from 2014, climbing from No. 37 to 31, while Oregon’s drop from No. 12 to No. 20 was the biggest decline from the previous year.

Contact Brett Hein at bhein@standard.net, follow on Twitter @bhein3 and find him on Facebook.