Oklahoma dropped two spots in an annual national health ranking to become the third-unhealthiest state in the union.

The state is ranked 48th in overall health, compared to 46th last year, in America's Health Rankings by the United Health Foundation.

Louisiana and Mississippi were the two states ranking worse than Oklahoma.

The main reasons for Oklahoma's poor status are high rates of smoking, obesity and diabetes, as well as the low number of primary care physicians per capita.