West Virginia, often associated with dismal health statistics for its high rates of obesity and smoking, improved to its healthiest ranking ever despite lingering health problems, according to a national report released Tuesday.

 The Mountain State ranked 41st overall in the nation this year, up two spots from 2010, in the United Health Foundation's annual state-by-state health rankings.

 West Virginia was helped by a strong improvement in the percentage of children immunized against disease, according to the data in the report.

 That's the state's best ranking since the foundation's first analysis in 1990. West Virginia received its worst ranking, 49th, in 1991. The health rankings are based on factors such as public health policies, access to health care and the number of people getting immunized against disease, among many other factors.

 However, West Virginia has not shown any improvement since 2010 in its health "outcomes," which measures factors such as prevalence of diabetes, a person's poor mental or physical health days, child deaths and deaths related to cancer or cardiovascular disease.

 For the second year in a row, West Virginia ranked best in the U.S. in the lowest reported number of infectious-disease incidents, with a low prevalence of measles, pertussis, hepatitis A and syphilis.

 The state also has a low prevalence of binge drinking, ranking third. Binge drinking is the consumption of, in a short period of time, five or more drinks for men and four or more drinks for women.

 The state's public-health spending is $144.45 per person, fourth in the nation -- a significant figure reflecting how unhealthy the population really is, said Dr. Rahul Gupta, director of the Kanawha-Charleston Health Department.

 "The numbers speak for themselves. That shows you the lack of leadership. There's no focus," Gupta said.

 West Virginia has a high prevalence of smoking, obesity and diabetes, according to the report. Unlike other states, smoking rates have not dropped in the last 10 years, according to the study. Smoking hasn't declined in West Virginia in about 16 years, Gupta said.

 The Mountain State is ranked 50th -- worst -- in the nation in smoking; 26.8 percent of West Virginians smoke cigarettes, a drop from 2010's ranking of 49th, when about 1 percent fewer people smoked.

 The state spends more than $7 million in tobacco prevention, but obviously efforts are not working, Gupta said.