Matthew Gilbert, 8, celebrates the birthday of his cousin Flora Maxwell in War, WV. Fully 30 percent of the county's residents are obese, compared to 17 percent nationwide, according to state and national studies. The diabetes rate is 92 percent higher than the national average. McDowel county tops all of West Virginia's 55 counties in deaths per capita and in incidences of diabetes, suicide and homicide.
(Michele McDonald/Globe Staff)