It’s a fact that’s hard to fathom: Hunger still exists in the country with the world’s largest economy and one of the highest national rates of obesity.

According to a recent report by the National Commission on Hunger, a bipartisan panel created by Congress, almost 7 million American households had experienced hunger at some point in the past year as of 2014. Here hunger refers to what is also called “very low food security,” which is when “eating patterns are disrupted or food intake is reduced for at least one household member because the household lacked money and other resources for food.”

Individuals and families with earnings under or near the poverty line are of course at worst risk of hunger. Thus black and Hispanic households, who face higher rates of poverty and unemployment, go hungry more often than white households. For similar reasons, single-mother families suffer very low food insecurity at four times the rate (12.8%) of married-parent families (3.2%). Single-father families also face elevated rates of hunger (7.0%).

Needless to say, lacking a consistently adequate, healthy diet spells a multitude of problems for children: impaired growth, a weakened immune system, and a higher likelihood of hospitalization, as well as cognitive deficits and greater liability to poor behavior and poor mental health.

Hunger undermines adults’ physical and mental health, too, of course, and their poor health can further imperil the well-being of children. Depression among mothers, for example, appears to be both a result of and a contributor to food insecurity, and depressed women may struggle more to be good parents. As one woman recounts in the commission’s report:

The cycle of hunger has never left my family. My siblings
 and I lived with my mom growing up, and we struggled with hunger. When she died, we went to live with my dad. And we struggled then. The stress of having no food affected him.
 He couldn’t deal. He was so overwhelmed he started drinking instead of eating, and he sent us down South to our aunts, thinking we’d be better off. But we still were hungry there. And on top of that, we were missing our dad, and missing our mom. Hunger destroys people. It destroys families.

Perhaps the most surprising finding of the commission is this: the overall rate of household hunger—5.6%—has remained around its recession-era level even as the economy has recovered and millions more Americans have enrolled in the Supplemental Nutrition Assistance Program (a.k.a. food stamps). As the commissioners note, “America has no shortage of food, and no shortage of food assistance programs. But those programs do not work as effectively, cooperatively, and efficiently as they should.” They see the root causes of persistent hunger as not only low income and deficient assistance but un- and under-employment, lack of education, exposure to violence, family instability, a history of racial and ethnic discrimination, and personal choices.

What more can be done to fight hunger if this array of complicated, inter-related problems are ultimately at fault? The National Commission on Hunger recommends multiple reforms to SNAP and child nutrition programs; improving nutrition assistance options for the disabled and medically at risk; testing interventions through pilot programs; and more. Individuals and families with low food security, and ultimately all Americans, will be better off if they succeed in their goal of ending hunger entirely.