Cardiovascular deaths are up 2 percent from 2015 and have been identified as one of the fastest-growing health problems in the U.S., the United Health Foundation (UHF) reported this week in its 28th annual ranking report.

“America’s Health Rankings” is a yearly analysis that looks at 35 measures to quantify states’ wellness, including behaviors, community, environment, policy, clinical care and outcome data. The UHF calls the report “a call to action for individuals and their communities” and this year ranked Massachusetts as the healthiest state in the U.S.

But Massachusetts, the UHF reported—or any of the healthiest-ranked states in the union, for that matter—isn’t immune to looming healthcare concerns. The state experienced a 69 percent increase in drug deaths since 2012, and the fourth-healthiest state, Utah, has seen one of the country’s largest increases in cardiovascular deaths in five years.

These mortality trends are “concerning,” the UHF said. America’s premature death rate dominated statistics this year, climbing 3 percent since 2015 and reaching a total of 7,214 years lost before age 75 per 100,000 people. Past data states that same rate declined a dramatic 20 percent between 1990 and 2015.

Officials wrote 2017 was also a significant year for cardiovascular mortality, having increased 2 percent over a two-year period. Minnesota, Colorado, Massachusetts, Hawaii, Arizona, Washington, New Hampshire, Oregon, Connecticut and New Mexico ranked in the top ten for least cardiovascular deaths this year, while the bottom ten included Missouri, Michigan, West Virginia, Kentucky, Tennessee, Louisiana, Arkansas, Oklahoma, Alabama and Mississippi. Two of those states, Utah and Vermont, fell at the top of the overall health ranking list despite these striking numbers, taking third and fourth place in the top ten, respectively.

Mississippi took the cake for the worst rate of cardiovascular deaths in 2017, the report read, with 352.5 cardiovascular deaths per 100,000 people. Minnesota grabbed the top prize for the best rate, at 189.7 CVD deaths per 100,000 individuals.

Men showed a significantly higher CVD death rate than women, according to the data, and black patients were statistically more likely to die from the disease than whites, Hispanics, Asian/Pacific Islanders and American Indians/Alaska Natives. White CVD mortality has remained relatively steady in the white population, but in Asians, Hispanics and blacks, those death rates have declined over the past half-decade.

Since 2015, the UHF reported, cardiovascular mortality has increased in 21 states and only declined in California. In the past five years, New York and West Virginia saw the greatest improvements, while Nevada and Utah saw the highest increases.

Obesity—a leading risk factor for CVD—had claimed 29.9 percent of the U.S. adult population by 2017; the condition cost an estimated $315.8 billion in 2010. Colorado was the highest-ranking state for combating obesity with a rate of 22.3 percent, while West Virginia was the worst at a 37.7 percent. Just over 23 percent of American adults also suffer from physical inactivity, according to the report, and 10.5 percent live with diabetes.

According to the UHF, cardiovascular illness accounts for 17 percent of the country’s medical spending and 30 percent of Medicare spending.