Food is a basic need that many people take for granted. Yet, 48 million Americans face limited access to adequate amounts of nutritious food. Many who are food insecure rely on food stamps and on cheap, unhealthy food options.

Food insecurity is a major problem in the United States, one that would cost an estimated $24.6 billion to alleviate in a given year. The tens of millions of Americans living in households that face hunger or lack access to adequately nutritious food tend to share some common defining characteristics. 24/7 Wall St. reviewed data on food insecurity from Feeding America, a nonprofit that operates a network of food banks across the United States, in order to determine the county with the highest share of food-insecure residents in each state. Across the country, food insecurity ranged from 4.3% in Loudoun, Virginia, to 35.7% in Holmes County, Mississippi.

Food insecurity, as defined by the U.S. Department of Agriculture, is a household-level economic and social condition of limited or uncertain access to nutritionally adequate food.

Click here to see the counties going hungry in every state.

In an interview with 24/7 Wall St., Ross Fraser, media relations director of Feeding America, explained what this can look like across the country. According to Fraser, food insecurity affects individuals and families with varying degrees of regularity. It can “be something that affects a family only a couple of times a year… or it could be someone who’s homeless or has no household income for whom accessing food is a daily struggle.”

The causes of food insecurity are just as diverse as the range of people it affects. Chief among these is poverty. Fraser explained that high-protein food and fresh produce can often be very expensive and “out of the reach of someone who’s struggling on a very limited budget.” Unsurprisingly, in 44 of 50 states, the poverty rate in the most food-insecure county is greater than the nationwide poverty rate.

While poverty is a core component of food insecurity, nearly half of all food-insecure Americans earn more than 130% of the poverty level. Fraser pointed out that since the recession, unemployment has also become an increasingly relevant causal factor. Unemployment in 41 of the 50 counties examined is higher than the national unemployment rate. Fraser further noted that, those who once had relatively high salaries and commensurately high expenses and standards of living, and then suddenly lost their job may find it very difficult to afford food.

The lack of healthy eating options can also drive up food insecurity. “There simply aren’t grocery stores with an array of fresh foods in many parts of the country,” said Fraser. In many rural areas, “it’s not financially feasible for a major chain to open a retail store.” Perhaps not surprising, the majority of counties suffering from high food insecurity are more rural than the country as a whole. Urban areas are by no means immune, however. Several food-insecure counties are located in major cities. Such food-insecure areas include Baltimore, St. Louis, Philadelphia, and Brooklyn.

Aside from hunger, food insecurity can lead to an array of additional adverse health conditions. Perhaps somewhat counterintuitively, food insecurity can often lead to obesity. Fraser explained that food-insecure people tend to buy inexpensive, highly processed food. And these foods are often high in calories, sodium, and fat. Partially as a result, in the majority of counties struggling with food insecurity, obesity is far more common than it is across the nation. “If you don’t eat a healthy, balanced diet, there can be terrible ramifications for your health,” Fraser said.

Government assistance through the Supplemental Nutrition Assistance Program, also known as food stamps, is helpful in the fight to reduce food insecurity, though it is often not enough. “For the average household receiving food stamps, they use up all of those benefits in the first 21 days of any given month,” Fraser said. This means a food-insecure households may have as many as nine days per month with no nutritional assistance. Food stamp benefit eligibility thresholds vary across the country from 200% of the poverty level in states such as New York and Florida to 130% of the poverty level in states such as Utah and Tennessee. For better or worse, all but seven of the counties struggling the most with food insecurity have a higher food stamp recipiency rate than the 13% nationwide figure.

To identify the county in every state with the highest food-insecurity rate, 24/7 Wall St. reviewed state, county and congressional district level food-insecurity data in the United States from national food bank network and advocacy group Feeding America. The average cost of a meal, per person, for food-secure and food-insecure individuals in an area also came from Feeding America. Feeding America also estimated the percentage of food-insecure children who live in households likely eligible for federal nutrition assistance in each county (households with income below 185% for 2014 federal poverty.) Poverty rates for all people, median household income, and the percentage of households receiving federal nutritional assistance (SNAP) are five-year averages through 2015 from the U.S. Census Bureau’s Community Survey. Annual unemployment rates for 2015 came the Bureau of Labor Statistics. We also looked at additional measures of health factors and outcomes, including obesity rates and rural population share, from community health advocacy group County Health Rankings & Roadmaps, which is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

These are the counties going hungry in every state.

1. Alabama
> Most food-insecure county: Wilcox
> County food insecurity rate: 33.0%
> State food insecurity rate: 18.8%
> County poverty rate: 40.6%

The typical household in Wilcox earns $23,406 annually, less than half the amount the typical American household earns. Lower incomes in the county coincide with pervasive poverty. More than 40% people in Wilcox live below the poverty line. With such a high concentration of poverty, approximately a third of Wilcox county’s 11,367 residents struggle to put food on the table.

2. Alaska
> Most food-insecure county: Ketchikan Gateway Borough
> County food insecurity rate: 15.2%
> State food insecurity rate: 14.4%
> County poverty rate: 11.5%

The typical Ketchikan Gateway Borough household earns $61,712 a year, considerably more than the $53,657 the typical American household earns. Families with adequate resources are less likely to lack access to healthy food. However, even with a relatively high median household income, a larger than average 15.2% share of county residents struggle to put food on the table.

3. Arizona
> Most food-insecure county: Apache
> County food insecurity rate: 26.4%
> State food insecurity rate: 17.1%
> County poverty rate: 35.9%

More than one in every four people in Apache County lack access to adequate food. Even worse, 41.5% of children in Apache County are considered food-insecure, more than in any other U.S. county. Home to parts of the Navajo Nation, 73.5% of area residents identify as American Indian. Residents of Indian reservations are at an especially high risk of food insecurity due to extremely poor socioeconomic conditions, and low access to nutritional foods. As is the case in many food-insecure counties, many Apache residents also struggle with obesity. Nearly a third of all Apache adults are obese, a higher share than in Arizona and the United States as a whole.

4. Arkansas
> Most food-insecure county: Phillips
> County food insecurity rate: 31.6%
> State food insecurity rate: 19.1%
> County poverty rate: 34.0%

At $41,264, the median household income in Arkansas is lower than in every other state except for Mississippi. In Phillips County, median income is $14,081 lower, and 31.6% of the county’s population is at risk of hunger or lacks access to adequate nutrition. This is a much higher rate than across Arkansas, where 19.1% of residents are considered food-insecure.

5. California
> Most food-insecure county: Siskiyou
> County food insecurity rate: 20.0%
> State food insecurity rate: 13.9%
> County poverty rate: 22.7%

Among California residents, 13.9% have unreliable access to nutritionally adequate food. In Siskiyou County, located in the northernmost part of the state, on its border with Oregon, 20% of people suffer from food insecurity. Food is often more difficult to access in rural environments, and while less than one in five Americans live in rural areas, nearly two-thirds of Siskiyou residents live in rural locations.

6. Colorado
> Most food-insecure county: Fremont
> County food insecurity rate: 16.6%
> State food insecurity rate: 12.9%
> County poverty rate: 17.6%

Colorado families are among the least likely in the country to suffer from inadequate access to food. Statewide, 12.9% of Coloradans face hunger or poor access to nutritious meals, compared to a national food-insecurity rate of 14.0%. At 16.6%, Fremont County has the highest rate of food insecurity in Colorado.

7. Connecticut
> Most food-insecure county: New Haven
> County food insecurity rate: 13.9%
> State food insecurity rate: 13.1%
> County poverty rate: 12.7%

New Haven County residents have the worst food insecurity of any county in Connecticut. Due largely to high incomes across the state, however, both New Haven and Connecticut families are less likely than those in many other areas to have uncertain access to nutritious food. New Haven’s median household income of $61,646 is higher than the national median income. The county’s food insecurity rate of 13.9% is actually slightly better than the national rate of 14.0%.

8. Delaware
> Most food-insecure county: Kent
> County food insecurity rate: 13.4%
> State food insecurity rate: 12.6%
> County poverty rate: 12.9%

The food insecurity rates in all of Delaware’s three counties is below the national rate of 14%. However, Kent County has the highest share of residents at risk of hunger or living with uncertain access to nutritious food options. Relative to the other two counties in the state, Kent also has higher rates of factors that tend to coincide with food insecurity, including the state’s highest obesity and unemployment rates.

9. Florida
> Most food-insecure county: Gadsden
> County food insecurity rate: 24.4%
> State food insecurity rate: 16.2%
> County poverty rate: 27.2%

On a national level, roughly one in seven Americans face hunger or lack adequate access to healthy food. In Gadsden County nearly one in every four residents suffers from food insecurity. Food insecurity can be caused by high poverty, and it is also more likely to occur in sparsely populated, spread-out areas — Gadsden has both. Gadsden’s poverty rate of 27.2% is much higher than the national poverty rate of 15.5%. Also, nearly two-thirds of the county’s population lives in rural areas compared to 19.3% of Americans who live in rural locations.

10. Georgia
> Most food-insecure county: Dougherty
> County food insecurity rate: 28.3%
> State food insecurity rate: 17.7%
> County poverty rate: 32.4%

Dougherty County, which contains the city of Albany, is one of the poorest in the state. Close to half of the county’s children, for example, live in poverty. Extreme poverty can keep individuals and families from affording the nutritious food needed to stay healthy, and eating a poor diet can result in health complications, including obesity. Of the county’s adult population, 37% are obese, 10 percentage points higher than the national obesity rate and among the higher rates of all U.S. counties.

11. Hawaii
> Most food-insecure county: Hawaii
> County food insecurity rate: 14.2%
> State food insecurity rate: 13.7%
> County poverty rate: 19.2%

The difference in the food insecurity rate between Hawaii overall and Hawaii County is only half a percentage point. However, as is the case in many of the areas with the highest food insecurity rates, adults in the county are more likely to be obese and far more likely to feel physically unhealthy than adults statewide. Food insecurity is often present in households living above the poverty line. Hawaii county is the only area on this list where a majority of food-insecure children are not eligible for government assistance.

12. Idaho
> Most food-insecure county: Madison
> County food insecurity rate: 20.5%
> State food insecurity rate: 14.7%
> County poverty rate: 35.7%

More than one in five people in Madison County struggle to put food on the table. Poor physical health can often be a direct consequence of poor nutrition, and adults in Madison County report an average of 4.5 physically unhealthy days a month, nearly a full day more than is typical across the state. Food stamp benefits, though often inadequate as a means of addressing food insecurity, can be helpful for families struggling to afford food. In Madison, despite the high poverty rate of 35.7% — one of the highest in the nation — only 11.2% of households receive food stamp benefits, lower than across both the state and the country.

13. Illinois
> Most food-insecure county: Jackson
> County food insecurity rate: 19.4%
> State food insecurity rate: 12.9%
> County poverty rate: 32.3%

Close to one in every five Jackson County residents, including children, struggle to access nutritious food or face hunger on a regular basis, well above the statewide food insecurity rate of 12.9%. Residents of rural counties are more likely to live in food-insecure households than residents of less rural areas. In Jackson, 37.2% of residents live in rural locations, nearly double the national proportion.

14. Indiana
> Most food-insecure county: Marion
> County food insecurity rate: 19.4%
> State food insecurity rate: 15.3%
> County poverty rate: 21.0%

Food insecurity is relatively common in Marion County, where nearly one in every five people regularly struggle to maintain a substantively and nutritionally sufficient diet. People living below the poverty line are more vulnerable to food insecurity, and 21% of county residents earn incomes below the poverty line. With the relative prevalence of food insecurity, many Marion residents receive government assistance. Across the county, 17.0% of of households receive some level of food stamp benefits, considerably more than the corresponding 12.5% statewide recipiency rate.

15. Iowa
> Most food-insecure county: Story
> County food insecurity rate: 15.4%
> State food insecurity rate: 12.4%
> County poverty rate: 21.9%

Iowa has one of the highest median household incomes and one of the lower poverty rates. Some 12.4% of state residents have poor access to food. In Story, Iowa’s poorest county, 15.4% of residents are food-insecure, higher also than the national food insecurity rate of 14.0%. While children are particularly vulnerable to the negative health outcomes associated with food insecurity, the share of county children living in food-insecure households is actually relatively low. Just 15.9% of children are food-insecure. Nationwide, the child food insecurity rate is 20.9%.

16. Kansas
> Most food-insecure county: Geary
> County food insecurity rate: 19.1%
> State food insecurity rate: 14.2%
> County poverty rate: 13.0%

In Geary County, 19.1% of the population struggles with food insecurity, a considerably larger share than the 14.2% of state residents. Nationwide, only about half of those living with food insecurity are eligible for government assistance in the form of food stamp benefits. Still, food-insecure individuals are far more likely to rely on food stamps. Despite the relatively high food insecurity in Geary County, however, the 9.9% food stamp recipiency rate is below the 13.0% of households nationwide who receive food stamps.

17. Kentucky
> Most food-insecure county: Harlan
> County food insecurity rate: 22.2%
> State food insecurity rate: 16.8%
> County poverty rate: 32.1%

Food insecurity disproportionately affects the unemployed. In Harlan, Kentucky’s least food-secure county, 11.7% of the workforce is in need of a job. In comparison, the statewide unemployment rate is only 5.4%. Harlan was once one of the nation’s most economically vibrant coal mining towns. Last year, however, the area’s last coal mine was shuttered, a reflection of the poor economic conditions driving the area’s food insecurity. The inability to consistently be able to afford nutritious food can negatively impact the overall health of those with poor access to food. Harlan County adults report an average 6.1 physically unhealthy days a month, more than in all but four other U.S. counties.

18. Louisiana
> Most food-insecure county: Madison Parish
> County food insecurity rate: 28.1%
> State food insecurity rate: 17.3%
> County poverty rate: 38.6%

Nationwide, people struggling with food insecurity are far more likely to live below the federal poverty line than food-secure individuals. In Madison Parish, 28.1% of the population is food-insecure, and 38.6% of the population lives in poverty. As is often the case in areas with high food insecurity rates, many Madison Parish residents struggle with obesity. More than two in five Madison adults are obese, considerably more than both the state and national proportions.

19. Maine
> Most food-insecure county: Washington
> County food insecurity rate: 17.2%
> State food insecurity rate: 15.3%
> County poverty rate: 19.0%

While many food-insecure individuals do not qualify for government assistance, SNAP benefits likely help many Washington County residents keep food on the table. Of households in the county, 24.8% receive food stamps, well above the state recipiency rate of 17.2%, itself one of the highest compared with other states.

20. Maryland
> Most food-insecure county: Baltimore
> County food insecurity rate: 23.8%
> State food insecurity rate: 12.7%
> County poverty rate: 24.2%

Maryland is home to some of the more affluent areas in the United States and also some of the more impoverished. The city of Baltimore, which includes a large share of the Baltimore metropolitan area, falls into the latter category. While just 12.7% of Maryland’s population is food-insecure, 23.8% of Baltimore residents face hunger or struggle to access nutritious food.

21. Massachusetts
> Most food-insecure county: Suffolk
> County food insecurity rate: 15.9%
> State food insecurity rate: 11.1%
> County poverty rate: 21.2%

Across Massachusetts, 11.1% of people do not have reliable access to adequate amounts of food, nearly the lowest food insecurity rate in the nation. In Suffolk County, however, 15.9% of people are food-insecure, the highest in the state and higher than the national level of food insecurity. Massachusetts residents are some of the nation’s wealthiest. The state’s median household income of $67,846 is sixth highest compared with all states, and statewide poverty rate of 11.6% is one of the nation’s lowest. In Suffolk, by contrast, 21.2% of people live in poverty.

22. Michigan
> Most food-insecure county: Wayne
> County food insecurity rate: 22.0%
> State food insecurity rate: 15.7%
> County poverty rate: 24.8%

Wayne County contains some of the poorest parts of the Detroit metropolitan area. Nearly 25% of residents live in poverty, compared to the state rate of 16.9% and the national poverty rate of 15.5%. Not surprisingly, a relatively high share of county residents suffer from food insecurity as well. Food insecurity can cause negative health consequences, and in Wayne County, an estimated 26,621 individuals for every 100,000 people die before the age of 75, the fifth highest premature death rate of any county in the country.

23. Minnesota
> Most food-insecure county: Koochiching
> County food insecurity rate: 13.4%
> State food insecurity rate: 10.4%
> County poverty rate: 15.9%

Only 10.4% of Minnesota residents suffer from food insecurity, a smaller share of the population than in every other state except for North Dakota. Even in Koochiching, the county with the highest share of residents struggling to put food on the table, only 13.4% of people are food-insecure, lower than the 14.0% nationwide share. Food stamps help many of those who would not otherwise be able to afford food. In Minnesota, the threshold for food stamp benefits is 165% of the poverty rate, more generous than in many other states. This relatively high threshold may help lower the food insecurity rate.

24. Mississippi
> Most food-insecure county: Holmes
> County food insecurity rate: 35.7%
> State food insecurity rate: 22.3%
> County poverty rate: 43.9%

In Holmes County, 35.7% of people face hunger or have difficulty accessing enough nutritionally adequate food, the highest food insecurity rate in the nation. While food insecurity is present in households living both below and above the poverty level, it is far more common in low-income households. Holmes County has one of nation’s highest poverty rates, at 43.9%. A majority of high food insecurity counties are in the nation’s rural areas. The vast majority of Holmes residents — 86.8% — live in rural areas.

25. Missouri
> Most food-insecure county: St. Louis
> County food insecurity rate: 26.8%
> State food insecurity rate: 16.8%
> County poverty rate: 27.8%

More than one in four people in St. Louis struggle to afford adequate amounts of food or have limited access to nutritional food options, a higher share than in any other county in the state. Inconsistent and unreliable sources of nutritious food frequently lead to adverse health outcomes. In St. Louis, 31.8% of adults are obese, a higher share than across the state and nationwide. Furthermore, county adults report an average of 5.0 physically unhealthy days, also more than the corresponding state and national figures.

26. Montana
> Most food-insecure county: Glacier
> County food insecurity rate: 21.0%
> State food insecurity rate: 13.6%
> County poverty rate: 32.7%

Nearly one-third of Glacier County’s population lives in poverty, the highest rate in the state. Not surprisingly, the county’s population is the most likely in the state to lack adequate access to food. Unemployment can often lead to conditions associated with food insecurity. In Glacier, more than 10% of the workforce is unemployed, compared to the state unemployment rate of 4.1%. The county is home to Glacier National Park, and the Blackfeet reservation. Residents of Indian reservations are at an especially high risk of food insecurity due to extremely poor socioeconomic conditions, and low access to nutritional foods.

27. Nebraska
> Most food-insecure county: Douglas
> County food insecurity rate: 14.2%
> State food insecurity rate: 13.0%
> County poverty rate: 14.7%

High unemployment rates can often result in higher food insecurity in a particular area, but this is not always the case. Douglas County has the highest rate of food insecurity in Nebraska at 14.2%, slightly above the national rate of 14.0%. However, just 3.3% of the county’s workforce is unemployed, in stark contrast to other counties with high food insecurity and a lower jobless rate than the vast majority of counties nationwide.

28. Nevada
> Most food-insecure county: Nye
> County food insecurity rate: 15.6%
> State food insecurity rate: 14.9%
> County poverty rate: 18.6%

Rural areas are significantly more likely to have poor populations, and because they are more sparsely populated, nutritionally adequate food options are likely less accessible for many residents. In Nye County, which is in the southern part of the state, 35.3% of residents live in rural areas compared to a national share of just 19.3%.

29. New Hampshire
> Most food-insecure county: Coos
> County food insecurity rate: 12.6%
> State food insecurity rate: 10.5%
> County poverty rate: 13.2%

Food insecurity is much less of a problem in New Hampshire than in most of the United States. Just 10.5% of residents face hunger or struggle to afford nutritious food, the third lowest rate of any state. Even in Coos County, which has the state’s largest proportion of residents who are food insecure, just 12.6% of residents lack availability to nutritious food — still lower than the national rate 14.0%.

30. New Jersey
> Most food-insecure county: Essex
> County food insecurity rate: 18.6%
> State food insecurity rate: 11.8%
> County poverty rate: 17.2%

The typical household in Essex County earns $54,499 a year, well below the state median income of $72,062 but still higher than the national median income — only a few counties with high food insecurity have median incomes above the national figure. Of county residents, 18.6% struggle to afford nutritionally adequate food versus the national food insecurity rate of 14.0%. The prevalence of food insecurity in the county could be due to the relatively high cost of food. The average meal in the county costs $3.72, well above the average meal cost of $2.89 per food-secure person.

31. New Mexico
> Most food-insecure county: McKinley
> County food insecurity rate: 25.3%
> State food insecurity rate: 17.2%
> County poverty rate: 36.6%

New Mexico’s poverty rate of 20.9% is the highest of all states except for Mississippi. In McKinley, the state’s most food insecure area, 36.6% of people live in poverty, nearly the highest rate of any U.S. country. As is almost always the case, food insecurity in McKinley disproportionately affects children. Of children in the area, 36.4% are food insecure, compared to the food insecurity rate of 25.3% among people of all ages in the county. Home to both a Navajo and Zuni reservation, over three quarters of McKinley County’s population identifies as American Indian. Residents of Indian reservations are at an especially high risk of food insecurity due to extremely poor socioeconomic conditions, and low access to nutritional foods.

32. New York
> Most food-insecure county: Kings
> County food insecurity rate: 20.0%
> State food insecurity rate: 13.5%
> County poverty rate: 23.4%

Kings County — more commonly known as Brooklyn, New York City — is the least food-secure in the state. Unlike the majority of highly food insecure U.S. areas, Kings is entirely urban. While food venues may be more numerous, the cost of a meal in the county is relatively high. The average meal cost $3.23, higher than the average cost of $2.89 among food-secure individuals nationwide.

33. North Carolina
> Most food-insecure county: Edgecombe
> County food insecurity rate: 25.7%
> State food insecurity rate: 17.7%
> County poverty rate: 25.3%

More than one in every four people in Edgecombe are food-insecure, the highest proportion of people struggling to access food in North Carolina. In the state, 17.7% of people are food-insecure, the fourth highest rate of all states. As is the case in most food-insecure areas, the median household income in Edgecombe of $33,892 is well below the national median of $53,657.

34. North Dakota
> Most food-insecure county: Rolette
> County food insecurity rate: 17.2%
> State food insecurity rate: 8.0%
> County poverty rate: 37.0%

No state has a smaller share of its population struggling to afford nutritiously adequate food. Just 8.0% of North Dakota’s population lives in a food-insecure household, and just 11.4% of state children struggle with food insecurity. These are much lower rates than the corresponding national rates of 14.0% and 20.9%, respectively. However, not all parts of the state are as food secure. In Rolette County, 17.2% of all residents and 28.9% of children face hunger. The Turtle Mountain Reservation is located in Rolette County and the majority of Rolette County residents identify as American Indian. Residents of Indian reservations are at an especially high risk of food insecurity due to poor socioeconomic conditions, and because they are often located in relatively remote, rural areas.

35. Ohio
> Most food-insecure county: Athens
> County food insecurity rate: 19.8%
> State food insecurity rate: 16.8%
> County poverty rate: 31.6%

Nearly 20% of Athens County residents are food-insecure, compared to a national rate of 14%. The rate is even worse for Athens’ children, as 27% live in households that struggle to afford nutritious food. Further, it appears that some portion of these children are eligible for aid they do not receive. Nearly 80% of the county’s food-insecure children live in households eligible for federal nutrition assistance, but only 20% of these households receive SNAP benefits.

36. Oklahoma
> Most food-insecure county: Choctaw
> County food insecurity rate: 21.7%
> State food insecurity rate: 16.8%
> County poverty rate: 27.7%

Rural areas tend to have higher rates of food insecurity as poverty tends to be higher and healthy eating options tend to be more sparse. In Choctaw County, which has the highest food insecurity rate in Oklahoma, more than two-thirds of residents live in rural areas, compared to a national proportion of less than one-fifth living in rural places.

37. Oregon
> Most food-insecure county: Crook
> County food insecurity rate: 17.4%
> State food insecurity rate: 15.2%
> County poverty rate: 20.8%

Oregon has the highest food stamp recipiency rate of any state, with 19.1% of households receiving these benefits. In Crook County, the rate is even higher, at nearly 25% of households. Even with one in four households receiving federal financial nutritional assistance, 17.4% of county residents cannot afford to maintain a nutritious diet, higher than the national share of 14.0% and the highest of any county in the state.

38. Pennsylvania
> Most food-insecure county: Philadelphia
> County food insecurity rate: 21.7%
> State food insecurity rate: 13.8%
> County poverty rate: 26.7%

Many of the counties with the highest food insecurity rates are located in rural areas, which tend to have high poverty rates and inadequate availability of nutritious food. Philadelphia County, however, which has the highest food insecurity rate in Pennsylvania, is entirely urban. Philadelphia County is the largest in the state by population, and 21.7% of its residents are food-insecure, considerably more than the state’s food insecurity rate of 13.8%.

39. Rhode Island
> Most food-insecure county: Providence
> County food insecurity rate: 15.1%
> State food insecurity rate: 14.0%
> County poverty rate: 18.0%

More than 20% of Providence households receive food stamps, the least food secure area in Rhode Island. By contrast, 15.5% of households nationwide receive food stamps. Many area residents struggling to put food on the table may not even qualify for food stamps, and for those who qualify, the subsidy may be inadequate. An estimated 77% of food-insecure children in Providence are eligible for federal nutrition assistance, higher than the comparable state percentage of 70% of children, itself ninth highest compared to states.

40. South Carolina
> Most food-insecure county: Allendale
> County food insecurity rate: 27.9%
> State food insecurity rate: 16.4%
> County poverty rate: 32.5%

Since fattening sugar- and carbohydrate-rich foods are often far cheaper than more nutritious options, residents of the most food-insecure areas are more likely to be obese than most Americans. In Allendale, where 27.9% of people have difficulty accessing enough nutritious food, 40.4% of adults are obese, one of the highest obesity rates in the United States. According to Feeding America, 90% of high food insecurity areas are located in the South.

41. South Dakota
> Most food-insecure county: Oglala Lakota
> County food insecurity rate: 26.2%
> State food insecurity rate: 12.4%
> County poverty rate: 52.6%

For families that struggle to afford food, the less healthy options are often cheaper and more convenient. For this reason, obesity rates tend to be higher in poor, food-insecure parts of the United States. Oglala Lakota County, which has the highest food insecurity rate in South Dakota, at 26.2%, is no exception. While 27% of U.S. adults and 30% of the state’s adults are obese, Oglala Lakota has an adult obesity rate of 44.5%, the fifth highest rate of any U.S. county. The County is located within the Pine Ridge Indian Reservation, and is primarily comprised of American Indian residents, who are particularly at risk of the socioeconomic conditions that lead to food insecurity.

42. Tennessee
> Most food-insecure county: Haywood
> County food insecurity rate: 23.9%
> State food insecurity rate: 16.9%
> County poverty rate: 23.7%

Since fattening sugar- and carbohydrate-rich foods are often far cheaper than more nutritious options, residents of the most food-insecure areas are more likely to be obese than most Americans. In Haywood, where 23.9% of people have difficulty accessing enough food, 40.1% of adults are obese, one of the highest obesity rates in the United States. While 27% of area households receive food stamps, one of the higher percentages, many families that could use the help may still not be receiving government assistance. An estimated 82% of children living in food-insecure households qualify for government subsidies, one of the highest such percentages nationwide.

43. Texas
> Most food-insecure county: Jefferson
> County food insecurity rate: 24.7%
> State food insecurity rate: 17.0%
> County poverty rate: 21.3%

Nearly one in four residents in Jefferson County, Texas, struggle to afford nutritious food. The situation is even worse for the county’s children, as 30% live in households that struggle to afford nutritious food. Obesity rates tend to be higher in more food-insecure areas, as families often tend to resort to less expensive and less healthy food when money is tight. While 28% of Texas’ adults are obese, Jefferson County’s adult obesity rate is 36.9%.

44. Utah
> Most food-insecure county: San Juan
> County food insecurity rate: 19.0%
> State food insecurity rate: 14.2%
> County poverty rate: 28.1%

San Juan’s unemployment rate of 7.8% is twice as high as the state jobless rate of 3.5% — itself one of the lowest rates compared to other states. Unemployed individuals are at greater risk of food insecurity, and food insecurity in San Juan is indeed more prevalent than across Utah. The percentage of households who receive food stamps in San Juan, at 18.1%, is also more than double than the state’s percentage of 9%, which is one of the lowest compared to other states.

45. Vermont
> Most food-insecure county: Orleans
> County food insecurity rate: 14.5%
> State food insecurity rate: 13.5%
> County poverty rate: 16.7%

The high food insecurity rate in Orleans County, Vermont is largely due to its remote location. Most highly food-insecure areas are predominantly rural, and in Orleans, 85.3% of residents live in rural areas. In addition to less access to grocery stores, residents of these areas are also more likely to live in poverty. Orleans’ poverty rate of 16.7% is only slightly higher than the national rate of 15.5%, however.

46. Virginia
> Most food-insecure county: Petersburg City
> County food insecurity rate: 28.1%
> State food insecurity rate: 11.8%
> County poverty rate: 27.5%

Virginia’s food insecurity rate of 11.8% is one of the lowest compared to other states. In Petersburg City County, the food insecurity rate is well over twice that, at 28.1%. The health of an area’s job market is closely tied to food insecurity. Among workers in the Petersburg City area, 9% are unemployed, in stark contrast to the state and national jobless rates of 4.4% and 5.3%, respectively.

47. Washington
> Most food-insecure county: Whitman
> County food insecurity rate: 20.0%
> State food insecurity rate: 13.7%
> County poverty rate: 32.7%

Compared to other counties with high food insecurity rates, Whitman’s unemployment rate of 4.7% is exceptionally low. A strong job market does not guarantee high incomes for residents, nor does it ensure food security. Nearly one in every three county residents live in poverty, and one in every five people struggles to put adequate food on the table.

48. West Virginia
> Most food-insecure county: McDowell
> County food insecurity rate: 22.1%
> State food insecurity rate: 15.3%
> County poverty rate: 35.2%

In McDowell County, 27.2% of households receive nutrition assistance through SNAP benefits, well above the statewide recipiency rate of 15.8% and more than double the national rate of 13.0%. Still, with the highest food insecurity rate in the state, at 22.1%, the assistance may be inadequate. A number of residents identified as food-insecure may not even qualify for food assistance.

49. Wisconsin
> Most food-insecure county: Milwaukee
> County food insecurity rate: 17.7%
> State food insecurity rate: 11.9%
> County poverty rate: 21.9%

Wisconsin has one of the lowest food insecurity rates in the country, with just 11.9% of individuals living in households that struggle to afford nutritious food. In Milwaukee County, however, 17.7% of residents are food-insecure, higher than the national share of 14.0%. Poverty is not the sole reason families do not have access to sufficient, nutritious food, but it is likely the clearest reason. While just 13.3% of Wisconsin’s residents live in poverty, 21.9% of Milwaukee County’s residents are impoverished.

50. Wyoming
> Most food-insecure county: Albany
> County food insecurity rate: 17.4%
> State food insecurity rate: 12.6%
> County poverty rate: 27.6%

The likelihood of food insecurity increases dramatically for unemployed individuals. Unlike all but two counties on this list, however, Albany’s unemployment rate of 3.1% is lower than both the state and national jobless rates. Also, only 5.2% of county households receive SNAP benefits, lower than the state recipiency rate of 6.2%, which is the lowest of all states. With a poverty rate of 27.6% and the highest food insecurity rate in Wyoming, the low reliance on government programs is not due to lack of need.

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