<p>Evidence for the co-occurrence of lacking food and clean drinking water is largely missing for high-income countries and has overlooked water’s importance for food safety. Here we examined how lacking food and food safety covaried with lacking clean drinking water, using World Risk Poll data from 121 countries across country-income levels (<i>N</i> = 124,003). Lacking food for more than a day in the past year was associated with lacking clean drinking water for more than a day in the past year. Participants who lacked both food and clean water, or either alone (versus neither) were more likely to experience food safety threats and be concerned about food safety. Relationships held across country-income levels. Low-income countries (especially in Eastern Africa) and high-income countries (especially in Northern America) showed compounded effects of lacking food and clean drinking water on food safety. Worldwide, food insecurity, food safety and water insecurity should be addressed jointly.</p>