An analysis of claims by Blue Cross Blue Shield of America finds Minnesota with one of the highest rates of depression in the country.

The health insurer examined medical claims from more than 41 million commercially insured members from 2013 to 2016 and compared the depression rates by state, age and gender.

Minnesota, with a depression diagnosis rate of 5.8 percent, ranks near the top of states. Hawaii has the lowest rate of 2.1 percent. Women living in Minnesota tied with Maine for the highest rate at 8.1 percent. Minnesota’s millennials ranked second behind Utah with a depression rate of 6.3 percent.

The Star Tribune reports 49 of the 50 states had rising rates of diagnosed depression during the time frame analyzed. Major depression is a mental health condition affecting more than 9 million commercially insured Americans.