Hoosiers are heavier, smoke more and are increasingly diabetic, compared to a year ago.
Indiana dropped four spots in overall health rankings since 2011, earning the distinction of the 41st healthiest state in the country, according to findings released by America's Health Rankings.
"The fact that Indiana's overall rank is 41 is pretty upsetting," said Nurse Practitioner Maureen Panares, director of the student health center at Purdue University Calumet in Hammond.
The report shows 30.8 percent of Indiana adults are obese, with a Body Mass Index of 30 or higher. The number was slightly lower last year, at 30.2 percent.
Smokers account for 25.6 of the state's adult population, compared to 21.2 percent of adults who identified themselves as smokers in 2011.
And 10.2 percent of Indiana adults answered "yes" to the question, "Have you ever been told by a doctor that you have diabetes?" That number is up from 9.8 percent last year.
Panares, who has a doctorate in nursing practice, said improving Indiana's rankings will take a community effort.
"Communities develop a lifestyle, just as individuals develop a lifestyle," she said. "A coordinated effort really has to come from a highly organized department."
Local stakeholders, such as school systems and public health departments, need to collaborate and address the issues. But, closing health departments works against that goal, she said.
The report shows the number of Indiana children living in poverty more than doubled over the last decade, from 10.8 percent to 23.6 percent.
And, although the state has increased its amount of public health funding from $33 to $44 per person over the past five years, it remains one of the lowest amounts in the nation.
Indiana ranks 49th in air pollution, 13th in youth obesity, 42nd in physical activity and 19th in binge drinking, among other findings.
The report is published by the United Health Foundation, American Public Health Association and Partnership for Prevention.