Nebraska ranks as the 20th most obese state in the country, according to a new study from the Trust for America’s Health. The state ranked 23rd on last year’s report, so the situation is worsening. Rich Hamburg, deputy director of the trust, says this study focused only on adults, but he says the obesity numbers for children are beginning to reflect a change.

Hamburg says the report reviews key programs that can help prevent and address obesity by improving nutrition in schools, increasing physical activity, expanding health care coverage and by making healthy foods more affordable.

For more than 20 years, the numbers have continued to worsen for all states but in the past few years, some states have shown dropping obesity rates among adults. Nebraska isn’t one of them. Last year’s study showed 29-point-six percent of Nebraska adults were obese, while this year, it’s risen to 30-point-two percent.