Mainers are pretty healthy.

Fat. But healthy.

The state improved to the eighth healthiest in the country, up from the 10th spot in 2004, in America’s Health Rankings, a report issued by the United Health Foundation.

Maine has a low crime rate, a low percentage of the population without health insurance, provides good prenatal care and has a low infant mortality rate. Further, the state has radically reduced the number of children born to teenage mothers and improved its vaccination rate for 19- to 35-month-old children .

In areas where the state has made it a priority, conditions have improved. Take, for example, smoking. Maine is a national model for its efforts to reduce smoking, and targets significant resources toward that outcome and targeted taxes toward cigarettes. The result: Smoking rates have significantly declined since 1990 and dropped 12 percent from last year’s level.

The state provides comprehensive sex education in public schools, and the rates of teenage pregnancy have declined.

Likewise, the state has aggressively expanded its Medicaid rolls, which reduces the number of people without insurance. This approach is criticized, especially by those who prefer a market-based health insurance system. Nonetheless, it does mean the state looks good in comparison to other places when considering the question of coverage.

On the bad side of the ledger, Maine has a high number of cancer deaths per 100,000 residents and has a problem with obesity and the number of limited activity days.

According to the report, the number of obese people in the state increased 17 percent in the last year. While the state has taken a hard line on smoking, it’s been slower to recognize the dangers of obesity.

During the last legislative session, progress was made on providing healthier food options for students and reducing the availability of junk food in public schools. Other legislation, which would have forced chain restaurants to post nutritional information on their menus, failed.

The followthrough on the recommendations from the Commission to Study Public Health, which listed 28 places to improve, has been inconsistent.

Even though Maine is listed as a healthy place to live, there’s work to do on the trouble spots. Progress in other areas shows that it’s possible to improve public health with smart policy. Trimmer waists need to be the next target.