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.