FAYETTEVILLE, Ark. (KNWA/KFTA) — RunReviews.com conducted an analysis to find out which states were in the best and worst shape, and Arkansas ranked near the bottom in its report.

The report fixed on two categories, health status and lifestyle indicators, and examined federal data for three metrics each across all 50 states and Washington, D.C. and ranked Arkansas 50th out of 51. Only West Virginia is in worse shape.

Here is how Arkansas compares to the national average in six categories:

  • Number of gyms: 7.9 per 100,000 residents, (national average: 12.3)
  • Exercised in Last Month: 70.3% (national: 76.9%)
  • Obesity Rate: 36.4% (national: 32.1)
  • Diabetes Rate: 13.2% (national: 10.8%)
  • Heart Disease Rate: 6.9% (national: 4.3%)
  •  Annual Medical Checkup: 76.0% (national: 74.9%)

The nation’s capital is the most in shape “state” in the country, followed by Massachusetts and Colorado. Overall, the 10 states in the best shape are mostly located in the Northeast and Western U.S., and many in the Southeast fell at the bottom of the list.

The states in the best shape tend to have low rates of obesity, heart disease and diabetes—and more gyms available nearby. In some states, though, there’s little relationship between residents’ health status and lifestyle indicators, underscoring that demographic differences, local infrastructure and other factors also influence health outcomes.

Nearly 50% of Americans put on weight during the COVID-19 pandemic, according to a study published earlier this year by the National Library of Medicine. In addition, the CDC reported that 13.8% of U.S. adults are in poor or fair health overall, a rate that’s been creeping up in recent years.

The country has high rates of chronic disease. One in three Americans are obese and one in nine have diabetes.

Among all six metrics studied for the report, obesity is the most closely associated with a state’s overall score. That means if a state has a lower obesity rate, it’s fair to assume they rank higher on the list of states in the best shape, and vice versa.

The full report is available here.