Hawaii was No. 24 overall in the U.S. News & World Report’s annual 2019 Best States rankings but took the top spot for health care.

U.S. News & World Report ranked the 50 U.S. states in 71 metrics across eight categories. Each category was assigned weightings based on the average of three years of data from an annual national survey asking more than 50,000 people to prioritize each subject in their state.

Hawaii received top scores for health care access, health care quality and public health. Approximately 5.5% of adults in the state are uninsured, well below the national average of 13.8%. Additionally, the obesity rate in the Aloha State, at 23.8%, was below the national average of 31.3%.

U.S. News & World Report named Queen’s Medical Center the best hospital in Hawaii, followed by Straub Medical Center and Kaiser Permanente at Moanalua.

Hawaii ranked much lower in other categories, including No. 36 for fiscal stability, No. 40 for economy and No. 46 for opportunity. The low ranking in opportunity came from a higher-than-the-national-average cost-of-living index.

For the first time, Washington state was ranked the No. 1 state in the country due to a booming economy, as well as high rankings that landed it in the top five for health care, infrastructure and education. Washington was followed by New Hampshire at No. 2, Minnesota at No. 3, Utah at No. 4, and Vermont at No. 5.