KNOXVILLE (WATE) – Too much smoking, lack of exercise and a large number of disabled seniors are all contributing factors for Tennessee scoring as one of the worst states in the nation for senior health.

Down one spot from last year, Tennessee is 44th in the nation for senior health, according to America’s Health Rankings. The ranking is part of a report by the United Health Foundation, a non-profit created by the parent company of United Healthcare.

Tennessee actually scored the worst in the nation for smoking among seniors. Since 2013, smoking increased 27 percent among adults over age 65, according to the report. More than 13 percent of adults over 65 currently smoke in Tennessee.

The state had an increase in obese seniors. Since 2016, researchers found obesity has increased 15.9 percent among adults over 65.