For the third consecutive year, Massachusetts was named the healthiest state in the U.S., according to Sharecare’s Community Well-Being Index.

The report was released Tuesday morning and found that the Bay State led the nation in healthcare access as well as several categories related to the social determinants of health (SDOH). 

Following closely behind was Hawaii, which received high marks for housing and transportation options, and New Jersey, home to many of the nation’s leading healthcare providers and pharma companies. The three leading states were commended for successful wellbeing metrics like financial security and the ability to handle stress.

Rounding out the top five were Maryland and New York, which maintained their respective ranks over the past three years.

At the bottom of the rankings was Mississippi, which retained its spot for the fourth consecutive year. Finishing near the bottom with Mississippi were Arkansas, West Virginia, Kentucky and Alabama.

The survey, which was conducted throughout 2022, indicated that the states with the lowest rankings had “recurring obstacles linked to individual health risks and SDOH.” None of the 10 lowest-ranked states finished in the lowest rankings for wellbeing in the community category, while eight of the lowest-ranked states lagged in areas of financial wellbeing.

The findings show how critical financial wellbeing is to overall health, with people nationwide expressing heightened concerns about the economic vulnerability associated with high inflation.

Additionally, there is a lingering gap between the haves and have nots when it comes to health in America.

“While we see a general trend towards recovery in well-being levels, the data also reveals persisting disparities between states, with a notable 17.4 point difference when comparing the top and bottom-ranked states,” said Dr. Michael Rickles, VP of research at Sharecare, in a statement.

Sharecare’s survey provides the latest data regarding the fragmented nature of healthcare in the U.S. and reinforces the general rankings of various states.

A study last November found that California was the healthiest state, followed by Massachusetts, Vermont and New Jersey. 

Another study released weeks later singled out West Virginia as the unhealthiest state in America, followed by Mississippi, Kentucky, Alabama and Arkansas.