Four in 10 American adults are clinically obese, and obesity rates continue to climb nationwide, a report from Trust for America’s Health finds.

The annual report, State of Obesity 2022: Better Policies for a Healthier America (92 pages, PDF), highlights what it describes as an obesity crisis linking poor nutrition and health to food insecurity and health disparities most often associated with poverty and social inequity. The report tracks rates of obesity and the associated age, race/ethnicity, and state of residence.

Nineteen states have adult obesity rates greater than 35 percent, with West Virginia, Kentucky, and Alabama topping the list with rates of 40.6 percent, 40.3 percent, and 39.9 percent, respectively. The District of Columbia, Hawaii, and Colorado had the lowest adult obesity rates at 24.7 percent, 25 percent, and 25.1 percent. Nationally, 41.9 percent of adults are clinically obese, while Black and Hispanic adults have the highest rates of obesity, with rates of 49.9 percent and 45.6 percent. White adults had an obesity rate of 41.4 percent, while Asian adults had an obesity rate of 16.1 percent. Overall, rural parts of the country had higher rates of obesity than did urban and suburban areas. According to the trust, a decade ago, no state had an adult obesity rate at or above 35 percent.

The release of the report coincides with the White House Conference on Hunger, Nutrition and Health, which is intended to catalyze public and private action to end hunger and improve nutrition and physical activity across the United States. Social and economic factors including poverty and the impact of structural racism and health inequities are strongly associated with obesity and are at the root of higher obesity rates in low-income communities that have fewer resources to support healthy eating and being physically active.

“The continued increase in rates of obesity across all population groups is alarming,” said Trust for America’s Health president and CEO J. Nadine Gracia. “We must advance policies that address the community, institutional, and structural factors that are barriers to healthy eating and physical activity and that exacerbate health inequities.”

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