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With over one-third of U.S. adults considered obese, there is growing concern over the social implications pertaining to the health and welfare of U.S. citizens. This study examines the impact of local food systems (i.e., access to healthy foods and unhealthy foods) and other control variables on adult obesity rates, general health conditions, and mortality rates in counties across the United States. The findings suggest that adult obesity disproportionately impacts people with less access to healthy food, fewer resources to make healthy food choices, and often lacking the health care needed to provide intervention and care for obesity related health concerns. Policies that seek to reduce obesity will require addressing the underlying socioeconomic and environmental conditions that prevent individuals from making healthier food choices. (C) 2016 The Authors. Published by Elsevier B.V.