The folks at Gallup do a yearly survey that determines a state-by-state picture of health. South Dakota finished this year at number three, bested by Alaska and Hawaii. Last year’s number one North Dakota fell all the way to the middle of the pack this year.

Using five essential elements of well being such as physical, social, financial and community relationships along with being motivated to achieve your goals fills out the data points to make the score. South Dakota topped the list for the social and community categories. Gallup interviews over 175 thousand adults for the survey.

Regionally, the Northern Plains and Mountain West score the best and the South and the industrial Midwest are usually the worst. Kentucky and West Virginia are the two states that traditionally scrape the bottom of this barrel.

Year over year stats show an interesting trend. North Dakota’s chart-topping score in 2013 was 70.4 with South Dakota at 70.0 in second place. Alaska’s aggregate winning score in 2014 was 64.7 with South Dakota’s third place mark at 64.3.

You could conclude that the nation’s well-being is on a slide. A 64.3 mark in 2013 would have been tied for number 44.