ANNAPOLIS, Md. (AP) — The Chesapeake Bay's health is going from bad to worse, according to an environmental group that gave bay health a grade of ''D'' on Monday for the ninth consecutive year.

The Chesapeake Bay Foundation gave the bay a failing grade for one of its most persistent pollutants, nitrogen, along with Fs for water clarity and dissolved oxygen.

''The health of the Chesapeake Bay is dangerously out of balance,'' a report from the foundation concludes.

The troubles are many. Underwater grasses, which are important because they provide habitat and filter pollutants from the water, continue to struggle to reach historical levels. The watershed is losing wetlands to erosion. Chemicals from myriad household products — antibacterial soap to face creams to birth control pills — end up in the water, making some fish unsafe to eat.

Even blue crabs, the hallmark critters of the Chesapeake, are suffering from overharvesting and loss of habitat.

''We must all voice our outrage so that those with the power to effect change — the governors and legislators at the state and federal levels — do more to implement the known solutions of reducing pollution,'' Foundation President Will Baker said in a statement.

The overall score was 28, down from last year's score of 29.

The only A score came for rockfish, or striped bass, which are near historic high levels, a rebound long considered the greatest success of Chesapeake restoration efforts. The foundation also praised Pennsylvania for planting more than 600 miles of forest buffers along waterways in 2006. The buffers help absorb pollutants that would otherwise run into the bay.

However, the news was mostly bad.

Bill Dennison, a scientist at the University of Maryland Center for Environmental Science, did not help compile the foundation's report card but said it is in line with what he sees: nagging problems in the bay, with slower success than scientists would hope.