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Americans are continuing to get fat, with obesity rates nudging upwards in 28 states over the past year, a new report shows.

“More than two-thirds of states now have adult obesity rates above 25 percent,” Jeff Levi, executive director of the Trust for America’s Health, said during a Tuesday news conference. “Back in 1991, not that long ago, not a single state had an obesity rate above 20 percent. There’s been a dramatic change in a relatively short period.”

“Obesity is one of the biggest public health crises in the country,” Levi added. “Rising rates of obesity over past decades is one of the major factors behind skyrocketing health care costs in the U.S., one-quarter of which are related to obesity.”

Mississippi weighed in for the sixth year in a row as the fattest state, with 33.8 percent of its adults obese, while Alabama and Tennessee tied for second (31.6 percent). The other top 10, also concentrated in the south, were West Virginia, Louisiana, Oklahoma, Kentucky, Arkansas, South Carolina and Michigan tying with North Carolina for 10th place (29.4 percent).

Michigan was the only state in the top 11 not in the South, an anomaly perhaps explained by the state’s economy.

“Michigan certainly has been very hard hit, not just in the recent recession, but in the last decade or so,” Levi explained.

And, as the report also shows, income is a major driver of the obesity epidemic. More than 35 percent of adults bringing in less than $15,000 a year were obese, vs. only 24.5 percent in the over-$50,000 income bracket.

The healthiest states in terms of weight were congregated in the Northeast and West. Colorado (19.1 percent) came in first, followed by Connecticut, the District of Columbia, Massachusetts, Hawaii, Vermont, Rhode Island, Utah, Montana and New Jersey. The District of Columbia was the only region to experience a decline in obesity rates.

In addition to geographic and economic differences, this year’s report also focused on racial and ethnic disparities, finding that blacks and Latinos bear the brunt of the obesity problem. Blacks and Latinos outweighed whites in at least 40 states plus D.C.

“Just over 30 percent of African-Americans and nearly 40 percent of Latino children are overweight versus 29 percent of white children,” Angela Glover Blackwell, founder and chief executive officer of PolicyLink, said during the teleconference.

As with adults, this puts them at higher risk of developing diabetes, high blood pressure and other risk factors for heart disease.

Racial/ethnic differences are closely intertwined with economic inequalities.

“The link between poverty, race and obesity is undeniable,” Glover Blackwell said. “For example, Mississippi, the poorest state in nation with an African-American population of more than 37 percent, has the highest obesity rate of any state and highest proportion of obese children.”

Poor and minority neighborhoods lack safe streets and parks in which to exercise and many are also so-called “food deserts.”

“Twenty-three million African-Americans do not have access to a grocery store within a mile of where they live, and only 8 percent of African-Americans live in a census tract with a grocery store,” Glover Blackwell said.

A poll on childhood obesity included in this year’s report found that 16.4 percent of children aged 10 to 17 are obese and 18.2 percent are overweight. Although the rates are troubling, the trend may have stabilized, the report said.

But the issue is at least getting on the radar, with 80 percent of Americans saying they believe “childhood obesity is a significant and growing challenge for the country.”

Some glimmers of hope have also appeared on the horizon, including “three major developments at the federal level,” Dr. James Marks, senior vice president of the Robert Wood Johnson Foundation, said during the teleconference. “This includes First Lady Michelle Obama’s ‘Let’s Move’ program; health care legislation that includes support for obesity-related projects; and many states and communities have mandated nutritional standards for school meals and snacks as well as foods sold in schools.”

“In the last few years, promising programs and policies have increased exponentially, but our response as a nation has yet to fully match magnitude of problem,” Levi said.

The report was co-authored by the Trust for America’s Health and the Robert Wood Johnson Foundation.