Iowa’s 2022 rate of 506 per 100,000 exceeds national 442 average
Just about every political candidate in Iowa agrees on one thing: something must be done about the state’s rising cancer rates. The midwestern state has the second-highest cancer rate nationwide and, together with Utah and West Virginia, is one of only three states where incidence of the disease is rising, according to monitoring from the National Institute on Minority Health and Health Disparities. Promises to address the issue have moved to the top of the campaign agenda ahead of the November 3 elections, in which Iowa may play an important role in deciding control of Congress for the final two years of Donald Trump’s term.
Iowa’s cancer rates tracked national trends until 2012, when they began climbing for reasons that Sarah Green, executive director of the nonpartisan Iowa Environmental Council, said remain unclear. One survey has ranked cancer as the top issue facing the state, eclipsing even the cost of living.
The contest for Iowa’s open US Senate seat has put the disease directly into the campaigns. Democrat Josh Turek, who attributes his spina bifida to his father’s exposure to Agent Orange during the Vietnam war, has spoken publicly about his sister’s struggle with breast cancer. His opponent, Republican Congresswoman Ashley Hinson, has emphasized her attempts to reform health policy in Washington. In Iowa’s four Republican-held US House districts, candidates of both parties have competed over who would be better suited to channel federal resources to the state’s needs.
In the race to replace the incumbent governor, Kim Reynolds, Republican Zach Lahn won an upset primary victory in June with the support of a political action committee connected to the “Make America Healthy Again” movement. Both Lahn and his Democratic opponent, Rob Sand, have unveiled lengthy plans to curb the disease. Lahn’s platform has largely focused on incentivizing farmers to change their practices to prevent water pollution while accusing major chemical manufacturers of misleading Iowans about their products’ safety. “We all know something is terribly wrong, but too many politicians from Washington DC to Des Moines have had their heads stuck in the sand while big ag and big pharma printed money,” Lahn said after winning the nomination. “This will not go on when I’m governor.” Sand has called cancer “the top issue on everyone’s mind no matter what part of the state I’m in, and rightfully so,” and proposed measures to manage farmers’ use of manure, test for radon and help farms enroll in conservation programs.
Neither candidate has a platform as aggressive as that of Chris Jones, the Democratic candidate for state agriculture secretary. A former University of Iowa researcher, Jones wrote a popular blog exploring the state’s water quality issues but stopped writing it after, he told the Iowa Capital Dispatch, two Republican state senators threatened the university’s funding over his writings. One of the lawmakers denied the allegations, and Jones later left the school. Jones is proposing a wholesale transformation of the state’s approach to farming to reduce its impact on water quality, including zoning changes to address the environmental effects of concentrated animal feeding operations and a “strategic retreat” from growing corn for ethanol. “We know radon is a driver of lung cancer here. Well, guess what? We have policies to help reduce exposure to radon,” Jones said. “The same could be said for nitrate and drinking water. Let’s develop policies that reduce that risk.” The incumbent, Republican Mike Naig, a former lobbyist for Monsanto, the manufacturer of Roundup that is now part of Bayer, did not respond to an interview request sent to his campaign.
Iowa’s status as an agricultural powerhouse provides the backdrop for the debate. The state is the top producer of corn and pork in the US and one of the largest growers of soy, with agriculture generating a third of its economic output and a fifth of its jobs. Iowa’s farmers use more fertilizer than those of any other state, and the state leads the nation in the number of concentrated animal feeding operations (CAFOs), which are part of the meat processing supply chain and generate runoff. Green said Iowa has relatively few regulations intended to keep pesticides and farm runoff, which can be heavy with cancer-linked nitrates, away from people and out of water supplies.
Some Iowa waterways are among the most polluted by nitrates in the US. Last year, the water utility serving Des Moines, the state capital and largest city, announced its first-ever lawn watering ban because nitrate levels in the rivers from which it draws its water supply had hit near-record levels; the utility ordered water rationed again this summer. Iowa also has elevated rates of non-Hodgkin lymphoma and acute myeloid leukemia, two cancers that some studies have found may be linked to glyphosate, the fertilizer marketed as Roundup that is the most used in the state.
The Iowa Environmental Council last year dispatched researchers across the state to learn how cancer was affecting residents. Green said that talking about the link between cancer and agriculture was often regarded as a “taboo.” The council convened 16 listening sessions together with the Iowa Farmers Union and Drake University’s Harkin Institute. “Iowans knew there were issues, but felt like they were not supported by their state and by elected officials in, one, hearing their stories, and then two, addressing and recognizing real challenges that Iowans are experiencing a health crisis,” Green said.
Other factors also bear on cancer diagnoses in Iowa. Residents face higher risk of exposure to naturally occurring radon, and this year the state legislature approved a law mandating that mitigation systems be installed in new homes. Under Reynolds, the state has sought to curb alcohol and tobacco use; in June, the GOP-dominated legislature approved a $320 million investment in water quality. Green said that measure offers relatively little new funding and “doesn’t address pollution at the source.” Both Lahn and Sand came out against a June Iowa Supreme Court ruling that made it more difficult for people who believe they contracted cancer from exposure to Roundup to sue its manufacturer.
Some farmers are not waiting for the election. Last March, three farmers in north-central Iowa announced themselves as “the Lobe Rangers,” unveiling a website complete with a logo of a masked man standing amid the corn to make their case for how it is possible to farm profitably without harming themselves or the environment. “This has been boiling underneath the surface for me for 15 years, and the reason I think we launched is that we just kind of had enough,” said Zack Smith, a corn and soybean farmer who is one of the rangers. “We saw the inaction of the political class and the ag lobbying leadership class of putting up the same nonsense.” The group, which took its name from a particularly fertile part of the state called the Des Moines lobe, follows the state’s nutrient-reduction strategy, a voluntary blueprint to keep nitrates out of the state’s waterways and the Gulf of Mexico.
Seth Watkins, a longtime farmer in south-west Iowa who works land his great-grandfather first cultivated in 1848, has in recent years downsized what was once a 4,000-acre farm, helping younger farmers grow diversified crops on smaller plots. “The road I live on, I think there’s only one family that has not dealt with some kind of cancer,” Watkins said. He described the long-standing emphasis on farm policy as having produced an agriculture with “less soil, less biodiversity in wild species, more cancer, fewer farmers and fewer opportunities.” Watkins added: “I feel like we’re mining instead of practicing agriculture. And, you know, show me an area, whether it’s the oil industry or mining or any of that, where when the resources are gone, the people are better off.”
The Lobe Rangers have not endorsed any candidates. Smith said he doubts any single election can reverse Iowa’s health trajectory. “It’s definitely not gonna be solved by what’s gonna happen in the election in 2026,” he said. “We’ll maybe start making some steps in the right direction, but this is going to be something that is going to take a lot of change at a lot of different levels.”