Every year, the Centers for Disease Control and Prevention (CDC) ranks the healthiest states based on a number of factors including obesity rates, smoking, diabetes, and physical inactivity. According to the United Health Foundation's "2013 America’s Health Rankings," Hawaii is in first place as the healthiest place to live in the U.S. One reason being is that their smoking prevalence has decreased from 16.8 percent to 14.6 percent, and they have one of the lowest prevalences of obesity. However, there are also negatives such as a high rate of binge drinking, a low high school graduation rate, and high incidences of salmonella infections. Things are starting to look up, though. This past year Americans improved in more than two-thirds of the measures used in America's Health Rankings. Below is a list of the other 19 healthiest states in America — the results may surprise you.

20. Wisconsin - Obesity increased in the cheese state from 27.7 percent to 29.7 percent of adults; more than 1.3 million adults are obese in the state.

19.  Rhode Island - Smoking decreased by 15 percent from 20 percent to 17.4 percent of adults. More than 150,000 adults still smoke.

18. Iowa - The number rank is a low for Iowa in the past 24 years. This may have something to do with the high population of physically inactive and obese adults.  However, in the past 10 years, rate of cardiovascular deaths decreased and they have a historically low infant mortality rate.

17. Wyoming - Smoking has decreased by 5.5 percent, but 89,000 adults still smoke in Wyoming. Their obesity rates have also decreased since 2012.

16. Maine - Diabetes continues to rise as 110,000 adults have the disease, and there was also a slight increase in obesity, rising from 27.8 percent to 28.3 percent.

15. New York - Has one of the lowest obesity rates in the nation; however 3.5 million adults are still obese. And children in poverty increased from 20.4 percent to 25 percent of persons younger than 18 years.

14. Washington - Nearly 1.4 million adults are obese, but the state has a lower prevalence of physical activity as compared to other states. Drug deaths also decreased 15.9 to 14.4 deaths per 100,000 population.

13. Oregon - The smoking prevalence increased from 15.1 percent to 17.9 percent of adults. More than 530,000 adults smoke. But cardiovascular deaths did decrease by 36 percent.

12. Idaho - Although they have one of the lowest smoking rates in the nation, close to 190,000 adults still smoke. In 2012, the high school graduation rate rose to 84 percent of incoming ninth graders who graduated in 4 years, which was the highest rate ever.

11. Nebraska - One in five adults smokes, that’s more than 260,000 adults. Physical inactivity decreased from 26.3 percent to 21 percent of adults.

10. New Jersey - Obesity increased in the past year and so did smoking; however, the rate of cardiovascular deaths decreased by one-third.

9. North Dakota - Poverty increased from 11.9 percent to 15.8 percent of persons younger than 18 years. More funds are allocated to public health; last year it was $78 per person and today it's $91 per person.

8. Colorado - It has the nation’s lowest obesity rate, but still, there is an increase in diabetes.

7. Connecticut - Although it has one of the lowest smoking rates in the nation, almost 450,000 adults still smoke.  Since 2011 the uninsured population decreased from 11.1 percent to 8.3 percent of the population.

6. Utah - They have the lowest smoking rates in the nation, but there are still 190,00 adults who still smoke.

5. New Hampshire - There are more than 300,000 obese adults in the state. The smoking population has decreased by 2.2 percent.

4. Massachusetts - They have one of the lowest obesity rates in the nation at 22.9 percent of the adult population, yet almost 1.2 million adults are obese in the state.

3. Minnesota - In the past 10 years, the rate of cardiovascular deaths has decreased by 40 percent.

2. Vermont - Smoking has decreased by 2.6 percent of the adult population and the rate of cardiovascular deaths has decreased by 34 percent.

1. Hawaii - Smoking prevalence has decreased from 16.8 percent to 14.6 percent, and they have one of the lowest prevalences of obesity in the country.