Much of McDowell County (and surrounding counties) are low-income/low access using vehicle access as of 2019 per the Economic Research Service.
This means
A slightly more complex measure incorporates vehicle access directly into the measure, delineating low-income tracts in which a significant number of households are located far from a supermarket and do not have access to a vehicle.
This measure also includes census tracts with populations that are so remote, that, even with a vehicle, driving to a supermarket may be considered a burden due to the great distance. Using this measure, an estimated 2.1 million households, or 1.8 percent of all households, in low-income census tracts are far from a supermarket and do not have a vehicle. An additional 0.3 million people are more than 20 miles from a supermarket.
Percentage of population lacking adequate access to food: McDowell county 23% - highest in WV
NJ ranged from 5 to 11% KY 7 to 23% Prevalence of food insecurity – 22.5% - highest in WV