By Hallie Detrick
Updated: February 13, 2018 11:20 AM ET

The Gallup-Sharecare Well-Being Index for 2017 paints a bleak picture of the general state of America.

The annual report, released Tuesday, showed that 21 states saw a decline in well-being while zero states saw an improvement—a first in the index’s nearly decade-long history. Although some physical and community well-being measurements improved, they were outweighed by the drop in measurements of purpose, social well-being, and mental health.

Where does your state rank?

The Top Five

  1. South Dakota: South Dakota topped the list this year, up from its No. 3 rank last year. It has ranked in the top six states in the index every year since 2013 and this year got the highest score for the “purpose” element.
  2. Vermont: Vermont tied South Dakota’s rounded score of 64.1 out of 100 possible points. (Vermont is ranked No. 2 because in terms of non-rounded scores South Dakota edged out Vermont by a fraction of a point) Last year, Vermont was ranked No. 6. It was the highest scorer in the physical and community elements.
  3. Hawaii: Hawaii dropped from the top-ranked state for well-being to No. 3 this year. Hawaii has been ranked in the top 10 states for well-being every year since the index started in 2008. The only other state to hold this distinction is Colorado, which was ranked 6th in this report.
  4. Minnesota: Minnesota improved its rank from No. 9 in 2016 to No. 4 in 2017. its highest rank was in financial well-being, where it came in third behind North Dakota and South Dakota.
  5. North Dakota: Rounding out the top five is North Dakota, which was ranked 16th in the 2016 index. It was ranked #1 in the financial element.

The Bottom Five

  1. (46) Oklahoma: Oklahoma saw an improvement in rank from No. 48 to No. 46 between 2016 and 2017, but a decline in overall score. This indicates its rank improvement is more a reflection of poor performance on the part of other states, rather than its own positive performance.
  2. (47) Mississippi: Mississippi declined from a rank of No. 41 in 2016 to No. 47 this year, with an accompanying decline in point value. It was ranked the lowest for financial well-being.
  3. (48)Arkansas: Arkansas declined in the rankings from No. 46 in 2016 to No. 48 this year. It was ranked second-lowest in social and physical well-being.
  4. (49)Louisiana: Louisiana was ranked No. 49 in 2017, down from No. 43 the previous year. This is the state’s lowest rank ever.
  5. (50)West Virginia: West Virginia was the bottom-ranked state for well-being with an overall score of 58.8, maintaining its rank from 2016. It has been among the bottom-ranked states in terms of well-being throughout the history of the index.

Biggest Decline

Maine and Alaska demonstrated the largest declines in the rankings, with Maine falling 20 places from its No. 4 rank in 2016 to its No. 24 rank in 2017. Alaska fell 23 places from No. 2 in 2016 to No. 25 in 2017.

The full list of states where well-being declined between 2016 and 2017 include:

  • Alaska
  • Arizona
  • Arkansas
  • California
  • Florida
  • Georgia
  • Hawaii
  • Louisiana
  • Maine
  • Mississippi
  • Missouri
  • Nevada
  • New Jersey
  • North Carolina
  • Ohio
  • Oregon
  • Pennsylvania
  • South Carolina
  • Texas
  • Virginia
  • Washington

The remaining states did not see statistically significant changes in well-being:

  • Alabama
  • Colorado
  • Connecticut
  • Delaware
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Montana
  • Nebraska
  • New Hampshire
  • New Mexico
  • New York
  • North Dakota
  • Oklahoma
  • Rhode Island
  • South Dakota
  • Tennessee
  • Utah
  • Vermont
  • Wisconsin
  • Wyoming
  • West Virginia

The report did not offer analysis on why 2017 saw an unprecedented decline in well-being, but it did offer recommendations for employers, state and community leaders, and other stakeholders to help improve well-being, including cultural and infrastructure shifts to foster well-being among communities.

This post has been updated to reflect further details provided to Fortune by Gallup-Sharecare about how South Dakota and Vermont were ranked.

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