INDIANAPOLIS (AP) — Hoosiers' weight problems, lack of exercise and other unhealthy habits landed Indiana a spot in the bottom 10 in a ranking of America's healthiest states released Tuesday.

America's Health Rankings lists Indiana 41st in its annual review, slipping four spots from last year. The report is published by the United Health Foundation, American Public Health Association and Partnership for Prevention.

Indiana Public Health Association Executive Director Jerry King told The Indianapolis Star that the low ranking came as no surprise.

"The trend of Hoosiers paying really serious attention to their health has always been a problem," he said.

The report found more than one-quarter of Hoosiers smoke, and more than 30 percent of adults are obese, about three points lower than the U.S. level. Just over 29 percent of Indiana's population has not had any physical activity or outside work within the past 30 days, giving them a sedentary lifestyle.

Other states moved up in the rankings, which may have helped to push Indiana down in the list, said Eric Wright, director of the Center for Health Policy at Indiana University-Purdue University Indianapolis.

But it's still a wake-up call, he said. Besides personal traits like obesity and smoking, bigger factors like air pollution and low public health funding contribute to Indiana's status. And physical health is reflected in economic health, he said.

"The bottom line is, this is very much intertwined with our economic health," Wright said. "If we don't have a healthy work force, we will not have a healthy economy. By promoting more public health, we will improve our economy."

The report, which considers behavioral, statistical and environmental factors, found Indiana spent $44 per person on public health, ranking it 47th among all states. Hawaii, which spends the most, spends $236.

"We don't do enough," Wright said. "If Indiana is serious about it, the Legislature should be putting more funding behind the State Department of Health to support us."

There were a few bright spots, though: Indiana fared better than other states when it came to binge drinking and the number of people who don't have health insurance. Earlier this year, legislators passed a law banning smoking in many public places, including restaurants. And Indiana University is opening two schools of public health, in Bloomington and in Indianapolis.

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