By Nina B. Elkadi for Sentient.
Broadcast version by Mark Moran for Iowa News Service reporting for the Sentient-Public News Service Collaboration

Iowa has a cancer problem: over 20,000 people are expected to be diagnosed with cancer in the next year, with over 6,000 likely to die from the disease. One of the most frequently cited reports in the state is produced by the Iowa Cancer Registry, which has historically refrained from mentioning agriculture as a potential factor in increasing cancer risk. Yet farming is the dominant industry in the state — over 85 percent of the land is devoted to agricultural use and millions of animals are raised on factory farms contributing to environmental pollution. A new initiative, co-developed by The Harkin Institute at Drake University and the nonprofit Iowa Environmental Council, aims to fill this gap and hone in on the role agriculture plays in increasing cancer risk. The initiative was announced at a conference on water quality, held at The Harkin Institute on April 16.

“Even though there are lots of groups talking about studying the high cancer rates, there are some groups that want to limit what we’re looking at when we’re having these conversations,” Adam Shriver, Director of Wellness and Nutrition Policy at The Harkin Institute, said at the conference. “They might want to look at personal behaviors like going to tanning beds or smoking or drinking. And we feel like there’s a really important part of the conversation that’s being left out.”

While behaviors like smoking and binge drinking are linked to higher cancer risk, the new initiative wants to see the link between agriculture and cancer investigated with the same rigor, especially given the prominent role of industrial animal agriculture in Iowa.

The overwhelming majority — 99 percent — of farmed animals in the U.S. are raised in factory farms. In Iowa, there are almost 124 million farm animals at any given time — around 55 million chickens, 53.4 million hogs, 11.5 million turkeys and 3.7 million cattle and cows. Manure spills are commonplace: a recent report by Food and Water Watch found that from 2013 to 2023, there were 179 documented manure spills that killed almost 2 million fish.

Sarah Green, Executive Director of the Iowa Environmental Council, tells conference attendees that Iowa’s cancer rate is not the only outlier statistic about the state. “Iowa has the most factory farm waste of any other state in the country. Iowa has more concentrated animal feeding operations than any other state in the country. Iowa is among the top five states with the highest industrial pesticide use,” she said. “What role do these factors play in Iowa’s cancer rates? What else might be at play?”

In Iowa, waterways are just as impaired as the health of its residents. Almost 2 million fish were killed from the manure spills that occurred in Iowa between 2013 and 2023. The 179 spills were documented throughout the state, with a major hotspot for spills in Iowa’s northwest corner, where hog and other livestock operations are especially dense. Earlier this year, the group reported that Iowa factory farms produce more waste than any other state, at 109 billion pounds of manure annually, based on U.S. Department of Agriculture data. In March, just one manure spill in northeast Iowa killed over 100,000 fish.

For the new initiative, researchers will conduct a review of existing scientific studies and reports for what the research shows (and what it doesn’t) about the connection between agriculture, both row crop and livestock operations, and cancer in the state. The next step is to determine whether there is sufficient evidence based on the review to recommend stronger public health policy. 

The project will also host 15 listening sessions around the state to allow Iowans to “share and record their lived experiences with cancer,” Green said. Public awareness is at the heart of the project. “This entire initiative is about each of you and about Iowans, making people’s lives better, giving families more years to make memories together, helping Iowans from all walks of life have healthier, longer futures in our state,” Green said. “The cancer crisis touches every single county in Iowa.”

The initiative is funded by the Walton Foundation, which provides funding to organizations working to protect rivers, “oceans and the communities they support,” as well as philanthropic organizations Builders Vision and Grace Communications and Iowa Radiology, a radiology imaging practice. Disclosure: Builders Vision and Grace Communications are donors to Sentient; donors have no say over Sentient’s editorial coverage or content.

In an email to Sentient, Jim Larew, legal counsel for the nonprofit environmental advocacy group Driftless Water Defenders, praised the new initiative, noting “those holding visible and prominent positions in cancer research in Iowa” have focused their attention on binge drinking, making no mention of industrialized agriculture. A more “objective” review is necessary, he wrote.

“Established institutions have a tendency to avoid naming environmental causes of cancer, which normally can be addressed by policy changes and, instead, point to behavioral contributors to new cancers. Such tendencies have the effect of insulating the investigating institutions from intense political pressures exerted by powerful industrial-agricultural oligarchs,” Larew wrote.

Shriver told Sentient in an email that the plan is to have the report on the literature review completed by fall of this year.


Nina B. Elkadi wrote this article for Sentient.


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Iowa is the nation's number one corn and soybean producer and federal polices are designed to keep it that way but more farmers are moving away from traditional crops to protect the state's waterways.

Corn and soybeans both require a lot of fertilizer, which eventually seeps into groundwater.

Lee Tesdell, owner and operator of the 80-acre Tesdell Century Farm, in rural Slater, about 30 miles north of Des Moines, has adopted conservation methods. Instead of relying on the "big two" crops, he has gone to a four-crop rotation to reduce the amount of fertilizer he needs.

"Soybeans, corn, oats and alfalfa would be just as profitable," Tesdell pointed out. "Yields would be similar (to) a corn-soy, corn-soy, corn-soy, or corn-on-corn."

Some farmers have pushed back on moving away from corn and soybeans because they have been so reliable and profitable for generations. Adding new crops also means adding new costs.

Tesdell noted pollution from fertilizer runoff has become so bad in Iowa, the state's largest utility company has banned lawn watering to reduce nitrates in groundwater.

"Central Iowa Water Works cannot produce enough potable water every day to both send us good drinking water and enough water to water our lawns that's below 10 milligrams per liter, which is the EPA standard for drinking water," Tesdell explained.

Gov. Kim Reynolds recently vetoed a bill which would have banned companies from using eminent domain to construct CO2 pipelines on Iowa farmland, further promoting fertilizer-hungry corn and soybean production which can threaten Iowa's waterways.


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Ohio's food and agriculture industry contributes $124 billion to the state's economy annually.

Some farmers, however, argue that government policies need to be revised to support farmers nationwide in cultivating healthier foods for Americans.

A report from President Donald Trump's Make America Healthy Again Commission blames a poor diet as one of the leading causes of childhood chronic diseases.

But Joe Maxwell, president of the nonpartisan ag watchdog group Farm Action Fund, said the government's policies are a major contributor to the problem.

"They could shift government food procurement towards healthier foods," said Maxwell, "using government dollars and purchasing power to shift the agriculture and food system."

The MAHA report also lists toxic materials, medical treatments, lifestyle, environment, government policies, and food-production techniques as potential contributors to chronic childhood illnesses.

Ohio farmers produce more than 200 different crops and livestock, according to the state's Department of Agriculture.

The Ohio Department of Agriculture reports there are over 76,000 farms in the state. And 95% of them are family-owned.

Maxwell said he wants the Trump administration to confront the current system, which he said routinely prioritizes profits of foreign-owned conglomerates over the interests of American farmers and families.

"The president could renegotiate the United States-Mexico-Canada agreement," he said, "and make sure that all beef and pork is labeled as Product of the USA."

Farm Action is also asking the government to shift subsidies toward healthier crops that grow fruits, vegetables and whole grains and to invest in local and regional food systems to strengthen rural economies and improve access to fresh food.



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A group of farmers says government policies need to change to support farms in West Virginia and elsewhere in cultivating foods that will improve Americans' health.

A report from President Donald Trump's "Make America Healthy Again" Commission blames a poor diet as one of the leading causes of childhood chronic disease. However, Joe Maxwell, president of the nonpartisan ag watchdog group Farm Action Fund, said the government's policies are a major contributor to the problem.

"They could shift government food procurement towards healthier foods," he said, "using government dollars and purchasing power to shift the agriculture and food system."

The "MAHA" report cites toxic materials, medical treatments, lifestyle, environment, government policies and food-production techniques as some of the many possible factors that cause chronic childhood diseases.

Farm Action believes ending support for big, corporate agriculture would help other farmers produce healthier foods.

Maxwell said he wants the Trump administration to confront the current system -- in which he said the profits of foreign-owned conglomerates are routinely prioritized over the interests of American farmers and families.

"The president could renegotiate the United States-Mexico-Canada agreement," he said, "and make sure that all beef and pork is labeled as 'Product of the USA.'"

Farm Action is also asking the government to shift subsidies toward healthy food crops such as fruits, vegetables and whole grains and to invest in local and regional food systems to strengthen rural economies and improve access to fresh food.


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