After decades on the rise, obesity rates have for the second year in a row showed signs of leveling off, a new report finds.

Even so, the condition is still at epidemic proportions, with more than a third of Americans considered obese, according to the State of Obesity report released Thursday by the Robert Wood Johnson Foundation and the Trust for America’s Health that analyzed figures from the Centers for Disease Control and Prevention. The burden remains highest among women, the less-educated and lower-income.

Only one state—Kansas—saw its obesity rate drop between 2015 and 2016, while obesity rates rose in Colorado, Minnesota, Washington and West Virginia. The state with the highest obesity rate was West Virginia at 37.7 percent, followed by Mississippi at 37.3 percent and Alabama and Arkansas, which tied for third at 35.7 percent. Colorado had the lowest rate at 22.3 percent.

By comparison, in 1985, no state reported an obesity rate higher than 15 percent, the report said.

“In our review of the policies and strategies, we found that many [states] show a lot of promise for reversing the trends and improving health—if we make them a higher priority,” said John Auerbach, president and chief executive of the Trust for America’s Health.

To combat obesity, states must continue to support policies that help Americans live healthier lives, said Donald F. Schwarz, M.D., of the Robert Wood Johnson Foundation. Such policies include funding programs that entice grocery stores to open in food deserts, spruce up community parks, and offer public school students healthier food options.

“We can’t afford to move backward,” Schwarz said.

Adult obesity rates by state for 2016 (Source: State of Obesity: Better Policies for a Healthier America)

Adult obesity rates by state for 2016 (Source: State of Obesity: Better Policies for a Healthier America)

Obesity is a risk factor for heart disease and stroke, the nation’s No. 1 and No. 5 killers. The condition is also associated with high blood pressure, diabetes, high cholesterol and other health problems.

Considering the sharp increases seen in the past for obesity rates, “this counts as a significant achievement,” American Heart Association CEO Nancy Brown said in a statement. “But with rates still far too high among both adults and kids, particularly among low-income and minority communities, leaders at all levels of government—local, state and federal—must take action and build on this progress.”

Among adults, the new report shows 48 percent of blacks and about 43 percent of Hispanics are obese, compared with 36 percent of whites.

But a longtime obesity researcher said interpreting those data requires the appropriate context.

Researchers and doctors have known for years about the differences in obesity rates among ethnic and racial groups, “but if we scratch the surface a little bit, what we actually see is a strong relationship between obesity and socioeconomic status,” said David B. Sarwer, Ph.D., associate dean for research and director of the Center for Obesity Research and Education at Temple University in Philadelphia.

Findings from the report also show obesity rates in children and adolescents have been stable during the past decade at about 17 percent. But children are becoming obese at an earlier age.