Colorado’s health hasn’t improved much in the years that the Colorado Health Foundation has been releasing its report card.

In fact, for the state labeled “leanest” and “most active,” health care advocates say there is a lot of room for improvement.

In its latest reiteration of the state’s health report card, the state earned a C in healthy beginnings, a measure of how healthy infants are in the state. That’s the same grade it’s gotten since 2009. In 2007, the first year of the study, Colorado earned a C-.

In the healthy children category, the state improved slightly – it earned a C-, up from a D+ the two previous years. However, a C- is what the state earned in 2007.

Healthy adolescents have held study throughout the five years of the study. The state’s adolescents earned a B-. And the healthy adults category also has been unchanged, with a B. The healthy aging category – judging the health of the state’s elderly – was a B for 2011, a slight drop from the A- it received last year.

The state still has the lowest obesity rate among adults, but that rate rose from 19 percent in 2010 to 22 percent in 2011. With the rise, Colorado loses the distinction of being the only state in the nation with an obesity rate below 20 percent.

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“While we’re making progress in some areas, Colorado can – and must – do better in regards to health,” said Anne Warhover, president and CEO of the Colorado Health Foundation. “Though the economic downturn of recent years has forced some tough budgetary decisions, Coloradans want affordable insurance, manageable out –of-pocket costs and access to healthy food and living. If all health care stakeholders work together to improve health and cut costs, we’re hopeful that future report cards will show an uptick.”

In El Paso County, the report looks much like the rest of the state: the county’s obesity rate is 21 percent; its childhood obesity rate is 14 percent. About 80 percent of adults in El Paso County participated in a leisure time physical activity within the past month, statewide the rate is 82 percent.

From 2008-2010, 80 percent of adults in El Paso County reported having a primary care doctor, slightly higher than the state rate of 78 percent.

However, mental health issues are more of a problem. The study shows that 13.9 percent of adults in the region reported stress and depression, the statewide rate was 12.4 percent. More people smoke in El Paso County – 17.7 percent. The Colorado rate was 16.9 percent, but fewer people binge drink. In El Paso County, 14.2 percent reported binge drinking in the past month, lower than the state rate of 15.9 percent.

Researchers and advocates believe prevention is the key to lower health care costs and improving health. A recent study estimates than an annual investment of $10 per state resident in prevention initiatives could save $232 million annually in health care costs after five year s – a return of $5.05 for every dollar spent. However, prevention efforts currently represent less than 5 percent of every dollar spent on health care in the United States.