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A report card on America's health is giving its highest grade ever as more people take steps to cut cholesterol from their diets and stop smoking, but it warns that 64 percent of adults are overweight.

The Prevention Index, released Tuesday, also determined more people are wearing seat belts, are not drinking and driving, and that more women are taking the cancer threat seriously and undergoing Pap smears and breast examinations.The index, sponsored by Prevention Magazine and based on polling by Louis Harris Associates, was started in 1984. The 1,250 adults surveyed scored 65.4 points out of a possible 100 in 1989, an increase of 0.6 over 1988 and 3.9 over 1984.

Here are some findings:

- Cholesterol: 48 percent of American households purchased low-fat and low-cholesterol foods in the month prior to the survey, up 9 percentage points from 1988.

- 28 percent of adults said they "try a lot" to eat fish twice a week, compared to 34 percent in 1986 when the question was first asked.

- Smoking: 4 percent of adults surveyed do not smoke. Of those who do smoke, 90 percent avoid smoking in bed - a serious fire hazard.

- Weight: 64 percent of American adults are now overweight. "Most worrisome was the three-point dip in the percentage of people who maintain their proper weight," the Prevention Index reported. "Despite all the diet books and programs, weight control remains a problem for a majority of Americans, and we have managed to maintain our status as the fattest nation on Earth."

- Stress: 63 percent of adults reported feeling under great stress at least once a week compared to 55 percent in 1984, with those at the lowest and highest household incomes most likely to feel under great stress several days a week.

- Seat belts: 60 percent of adults use seat belts with 63 percent who live in states with seat belt laws using them all of the time compared to 38 percent in states without such laws.

- Drug/alcohol use: 81 percent avoid driving after consuming alcohol.

- 11 percent of adults are heavy drinkers and drink four or more alcoholic beverages a day, little changed from 1984.

- There was a decrease in drug abuse among adults under 30 in 1989, with one in 10 saying they use drugs compared to two out of 10 in 1985.

- Cancer prevention: 79 percent of adult women report having a Pap smear to detect cancer every two years, compared to 75 percent in both 1984 and 1988. The proportion of women doing self breast examinations on a monthly basis increased to 51 percent in 1989, up 14 percentage points from 1984.

- Sleep: 62 percent get seven to eight hours of sleep each night.

- Exercise: 52 percent of American adults said they walked for exercise at least several times a week during the month prior to the survey, compared to 47 percent in 1988.