WASHINGTON - Another poor health ranking for Oklahoma.

According to a health report from the United Health Foundation, Oklahoma dropped four spots to the 47th healthiest state.

The ratings are based on 35 criteria, including access to healthcare, state policies, and cancer and heart disease deaths.

Hawaii ranked as the healthiest state and Louisiana rounds out the bottom of the list as the unhealthiest.

The report titled America's Health Rankings Annual Report, from the United Health Foundation, a nonprofit division of UnitedHealth Group, has been published every year since 1990.