The U.S. has been classified as a "noticeably problematic" place to be a journalist, according to the World Press Freedom Index 2019.
It has slipped three places to 48 out of 180 countries in the ranking, published on Thursday by the organization Reporters Without Borders (RSF).
The report cites the June 2018 killing of five people who worked for the Capital Gazette in Annapolis, Maryland, as a factor in the country's reduced press status, and noted President Donald Trump's continued attacks on the media.
"Amid one of the American journalism community's darkest moments, President Trump continued to spout his notorious anti-press rhetoric, disparaging and attacking the media at a national level," the report's authors noted.
In August 2018, the president attacked the media in a stream of tweets, saying the "fake news" media are "dangerous and sick," and in November 2018, the White House temporarily revoked the press pass of CNN reporter Jim Acosta. In March, President Trump's re-election campaign sent a memo to TV producers warning them about the "credibility" of six of his critics given their "outrageous and unsupported" prior claims.
Norway comes top of RSF's index for press freedom, followed by Finland and the Netherlands, while Eritrea, North Korea and Turkmenistan are the three lowest ranked countries. Saudi Arabia is ranked 172 in the list, down three places on 2018, after journalist Jamal Khashoggi was killed at the Saudi consulate in Istanbul in October.
RSF's report said the number of countries that are safe for journalists had declined, due to hostile political leaders and an "intense climate of fear."
"If the political debate slides surreptitiously or openly towards a civil war-style atmosphere, in which journalists are treated as scapegoats, then democracy is in great danger," RSF secretary-general Christophe Deloire said in an online statement on Thursday.
Malaysia's position in the ranking increased 22 places, after Mahathir Mohamad became the country's prime minister after ousting the Barisan Nasional coalition that had ruled the country for more than six decades. The Maldives also improved after new President Ibrahim Mohamed Solih pledged to ensure press freedom.
North and South America saw the greatest deterioration in press freedoms of any world region, due to the poor performance of the U.S., Brazil, Venezuela, Nicaragua and Mexico, where at least 10 journalists were killed last year.
RSF also listed the U.S. as one of the world's deadliest places to be a journalist, with six killed in 2018. Afghanistan had the highest number killed, with 15, in a separate report published in December.