A healthcare crisis has been quietly building in rural counties throughout the Midwest.

Take Missouri. The Top 10 counties with the highest rates of cancer are all rural. And access to doctors, nurses and clinicians, while always lower than in cities, has grown increasingly limited as hospitals throughout the region have closed.

Add to this the presence of pesticides. They are seen as a vital tool in ensuring that millions of acres of farmland yield the soybeans, corn, wheat and other crops that are the lifeblood of rural economies and feed and fuel nations.

But a growing number of studies have found associations between these chemicals and the risk of cancer and other health concerns. And in the U.S., government regulators allow more of these chemicals than in many other countries.

In Unyielding, a University of Missouri project for Investigate Midwest, the implications of these issues are being examined for the residents of rural communities, whose work is vital to the economy and whose needs are often overlooked.

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Unyielding was produced by students at the University of Missouri School of Journalism. The team included researchers, reporters, data analysts, photographers and graphic designers. The students, most of whom were seniors who graduated in May 2025, included:

Reporters: Mary McCue Bell, Alex Cox, Jonah Foster, Prajukta Ghosh, Adeleine Halsey, Ben Koelkebeck, Xander Lundblad, Lillian Metzmeier, Kyla Pehr, Seth Schwartzberg, Savvy Sleever and Mayci Wilderman.

Data and graphics: Alex Cox, Yasha Mikolajczak and Mariia Novoselia

Photography: Michael Baniewicz

For questions about the project, please contact Mark Horvit, horvitm@missouri.edu.