This is the third article in the six-part Barn Raiser series “Rethinking Immigration and Health on Maryland’s Eastern Shore,” drawn from the author’s research for her book Landscapes of Care: Immigration and Health in Rural America.

Mid-sentence during our interview, David, a local physician and community clinic director on Maryland’s Eastern Shore, paused, looked past me out the window of his office, and said quietly: “No matter what I do, I feel like I am just putting Band-Aids on things that need stitches.”

He had just told me about an undocumented farmworker with diabetes who couldn’t afford the $400 insulin pen that would allow him to manage his condition while working in 110-degree chicken houses. David had been getting pharmaceutical representatives to give him free samples, essentially running his own informal medication distribution system. When his supervisors told him to stop providing this “free care,” David’s response was simple: “Why? Nothing is stopping me from continuing to do this for him.”

This is the reality of rural health care: providers and patients must create makeshift solutions to navigate systems that weren’t designed for their circumstances. On Maryland’s Eastern Shore and across rural America, both health care workers and immigrants have developed what I call “Band-Aid care”—temporary, improvised responses to permanent, structural problems.

The art of health care improvisation

Band-Aid care emerged repeatedly during my decade-long fieldwork. Providers used this metaphor to describe the temporary measures they undertake help those who require sustained attention but are systematically excluded from formal health care systems like hospitals, skilled nursing facilities, and primary care physician practices.

But Band-Aid care is far more than quick fixes. It represents an entire informal health care economy that has become essential to rural communities—a complex web of bartering, rationing, hoarding, strategic noncompliance and pure goodwill that keeps people alive when formal systems fail.

Elizabeth, the nurse practitioner who operated the region’s only mobile health unit, embodies this approach. When she needs to keep the mobile clinic van for an extra day beyond the rental period, she uses her personal credit card and gets reimbursed later by the federally qualified health center where she works. “Otherwise, no one would get care,” she says matter-of-factly. Her mobile clinic operates from a burgundy Dodge minivan, setting up under blue pop-up tents in farm fields and processing plant parking lots.

In rural immigrant communities, effective health care often looks more like community organizing than traditional medicine

Laura, another nurse practitioner, described the “creativity” required when a migrant client arrived from Texas with only a referral for an ultrasound to follow up on a breast mass—no previous mammogram, no insurance and limited availability for the procedure. “I do not have the original mammogram. I do not have anything to follow up with, and I have got to figure out how to get her over to the hospital, which has very limited hours for mammography, without impacting her work environment. She also has no insurance. And so you get very creative.” Laura often goes out of her way to find providers and hospitals that can offer free or discounted rates for services.

Patients as partners in improvisation

Health care workers aren’t alone in this improvisation. Immigrants and rural residents have become experts at navigating inadequate systems through informal networks and with creative problem-solving.

Isabelle, who was undocumented and worked cleaning houses, developed relationships with the families she worked for—many of whom were doctors’ and lawyers’ wives. “One family paid for my insulin at Walmart for eight months. Another paid my schooling fees for two years,” she told me, as she was studying nursing at the time. Through personal and professional networks, she found people willing to drive her to appointments, help her find medications online and assist with immigration paperwork through an immigration consultant. “I have always had people, really good people around me. My neighbor drives me to appointments, and my son helps me find the medications online. I am lucky.”

Sara, a physician working with migrant populations, developed her own system for managing medication shortages. When pharmacies made duplicate prescriptions by mistake or patients couldn’t pick up medications due to cost or transportation issues, rather than throwing these medications away, Sara says she saved them for “a rainy day”—when she could redistribute them to clients who couldn’t afford prescriptions or couldn’t come into the clinic.

These aren’t isolated examples of individual kindness. They represent a systematic pattern of informal care transactions that have become integral to how health care actually works in under-resourced rural communities.

The structural forces behind Band-Aid care

Why has this improvised system become so necessary? The answer lies in the collision between rural health care’s structural challenges and the specific needs of immigrant communities.

Rural health systems have experienced decades of hospital closures, reduced Medicare reimbursements and health care consolidation that prioritizes profit over patient care. Even Federally Qualified Health Centers (FQHCs)—designed as safety nets for underserved communities—operate under severe resource constraints. Federal Medicaid spending in rural areas is estimated to fall by $137 billion in the next decade as a result of the Republican reconciliation bill passed in July, according to a recent KFF report. This would “represent the biggest rollback in federal support for health coverage ever,” wrote Larry Levitt, KFF’s vice president for health policy. As rural health systems struggle through the next decade of spending cuts, Band-Aid care may become more necessary across the country.

Randall, a provider whose mobile clinic was eliminated due to budget cuts, described trying to see 14 patients in less than an hour while processing blood samples in 90-degree heat: “They come with a bag where the label is faded, and it has got your name on it from last year, and they have four things that are really a problem.” The impossibility of providing adequate care under these conditions led him to focus on just a few immigrant labor camps, leaving others without services entirely.

For immigrant communities, these challenges are compounded by language barriers, transportation difficulties, insurance complications and fear of deportation. The result is a population with high health care needs but extremely limited access to formal care.

Beyond crisis response

What strikes me most about Band-Aid care is that it extends far beyond medical emergencies. Christine, a social services provider and nurse, says true care often means addressing what patients identify as their most urgent needs:

Anybody who is a provider knows that when somebody comes in, you can see their leg is practically ready to explode. But they are busy telling you their car broke down because that is the most important thing they need. So long ago, we learned to say, “What is the most important thing that’s happening at this minute? Let’s deal with that.” We honor what they think is a priority to stabilize their situation. We do what we call “stabilize the family,” interacting with landlords, utility companies, car mechanics, automobile insurance dealers, courts and public defenders.

Such a treatment process recognizes that health cannot be separated from housing stability, transportation access, legal status and economic security. This broader understanding of care also challenges conventional medical models that focus narrowly on clinical interventions. In rural immigrant communities, effective health care often looks more like community organizing than traditional medicine.

The ethics of improvisation

The prevalence of Band-Aid care raises important ethical questions. While these improvised solutions keep people alive and demonstrate remarkable human creativity and compassion, they also represent the failure of formal systems to adequately serve populations with significant needs.

Is it acceptable that health care depends on providers using personal credit cards, hoarding medications and working unpaid overtime? Should immigrants have to rely on informal bartering systems with their employers for basic medical care? These makeshift solutions, while admirable, shouldn’t be necessary in a wealthy nation with advanced health care infrastructure.

At the same time, Band-Aid care reveals something profound about human resilience and community building. These informal networks create relationships and mutual obligations that extend far beyond individual medical transactions.

David’s frustration about “putting Band-Aids on things that need stitches” reflects a deep truth about rural health care, and his willingness to continue providing insulin to his undocumented patients despite institutional pressure reveals something equally important. It represents a commitment to care that transcends bureaucratic boundaries, participating in what anthropologists call “moral economies”—systems of exchange based on reciprocity, care and shared responsibility rather than market logic.

Lessons for health care policy

Band-Aid care offers important insights for health care policy and rural development. Rather than viewing these informal systems as problems to be eliminated, we might ask what they reveal about what effective rural health care actually requires.

First, successful rural health care must be flexible and community-embedded rather than rigidly bureaucratic. The providers who are most effective are those who understand holistically their patients’ lives and can adapt their approach to local conditions.

Second, addressing rural health disparities requires confronting the structural inequalities that make Band-Aid care necessary in the first place: health care system consolidation, inadequate funding for safety-net providers, transportation barriers and immigration policies that make people afraid to seek care.

Finally, any sustainable solution must build on rather than displace the networks of care and mutual aid that rural communities have already created. The relationships, trust and local knowledge embedded in these informal systems represent valuable assets that formal health care systems should support rather than ignore.

Band-Aid care, with all its limitations, demonstrates that health care is fundamentally about relationships between people who care for each other despite structural obstacles. While we work toward systemic solutions to rural health disparities, these improvised networks of care remain lifelines for communities that formal systems have failed.

So, the next time you hear policymakers discuss rural health care, ask whether their solutions build on the creativity, relationships and local knowledge that already sustain these communities—or whether they risk dismantling the informal systems that, however imperfect, keep people alive when everything else fails.

The post Band-Aid Care: When Keeping Rural People Healthy Requires Creative Solutions appeared first on Barn Raiser.

Unyielding is a University of Missouri School of Journalism project for Investigate Midwest.

Over the hum of blow dryers and the flurry of hairdressing shears, Bobbi Bibbs welcomed clients into Studio 119, a salon in the heart of downtown Kennett, for 19 years. 

As someone who worked “behind the chair,” all of her trims, dyes and big chops came with stories of life in the small Bootheel town where she was born and raised. In a tight-knit community like hers, Bibbs explained, you know nearly everyone who you pass on the street.

“I feel like it’s another kind of branch of being a small town, because you get so connected with your people,” Bibbs said. “I’ve met every walk of life, I’ve met people that I’m still connected to, to this day, just from walking in my doors.”

When she enrolled in beauty school, her vision was to run her own salon — her own safe space. In 2021, she decided to make it happen in Kennett. 

“I wanted to be able to make a positive space for people where they felt good,” Bibbs said. “It was a very, very positive area, (a) very uplifting area … I have young girls, so I wanted to make sure that young girls felt good about themselves.”

Owning a fledgling small business can be tiring. Even still, the wave of fatigue Bibbs began to feel at the start of 2023 felt so unusual, so sudden. 

Bibbs persevered, pushing past her symptoms until they couldn’t be ignored.

“I guess you could classify me as a workaholic,” she said. “I didn’t have time to be sick, I didn’t have time to feel bad, so I really didn’t think that I was sick.” 

She spoke with her doctor — in true small-town nature, one of her close friends — who set her up with a colonoscopy. Bibbs anticipated an in-and-out exam. Her partner, Ryan Brooks, would take her back home afterwards. She had a business to run, after all.

As Bibbs’ sedation from her colonoscopy faded, she opened her eyes to find her doctor standing at the edge of the bed. From the expression he wore, she knew something was wrong. 

“He looked at me with such pity,” she said. “When he walked out of the room, I looked at Ryan, and I said, ‘I’m sick. I’ve got cancer.’ ”

She was right. The test found colon cancer. Soon after, Bibbs learned that the cancer had metastasized to her liver, automatically bumping it up to stage four. 

“That one was tough, just because I felt like, ‘I’m never going to be free,’ ” she said.

When cancer metastasizes, entering the bloodstream or lymphatic system and spreading to other parts of the body, the chances of entering remission generally grow slimmer. Based on conversations with her medical providers, Bibbs said she’ll never enter “full-blown remission.” Instead, she hopes to achieve NED — no evidence of disease.

“It’s called ‘no evidence of disease,’ because some way, shape or form, it’s always in there,” Bibbs said. “I’ll just carry it with me.”

There’s no way around it: Cancer is an ugly truth. It forced Bibbs to close her salon, scramble to find health insurance and fight for the care she needed.

But this isn’t Bibbs’ only truth. Positivity is imperative; without it, “your mind can tear you down quicker than your body will.”  

“I just try to be as positive about it as I can,” she said. “Because you can either have this and you can continue to live your life and try to be as normal as you can, or you can let it absolutely consume you.”

After her diagnosis, Bibbs took to TikTok as @ablondescancerchronicles to tell her story, hoping to spread even “a sliver of positivity” to others. By chronicling her cancer journey online, Bibbs wants to encourage others to be proactive about their health. 

Her TikTok account is a mosaic of “get ready with me” videos, storytimes and candid reflections through which she shares her lived experiences. Her goal is to remind viewers they’re not alone and to inspire them — whether that means encouraging them to take their symptoms seriously or to keep fighting the good fight.

Even offline, Bibbs is a fierce advocate for regular health screenings. In February 2024, she pushed for her brother to go in for his first colonoscopy. 

“He kicked, he screamed, he acted like a total baby, and I was like ‘You gotta do this for me,’” she said. “And they removed three spots off his colon, and when he got the biopsy back, they told him (if he hadn’t come in), within a year, he’d be sitting right here by me.” 

There has to be something

Kennett is nestled in the center of Dunklin County, a rural sprawl of agricultural land dotted with small communities. It’s also part of an L-shaped cluster of Southeast Missouri counties with some of the highest colorectal cancer rates in the state.

Dunklin County’s colorectal cancer rate is nearly 1.5 times higher than the Missouri average. Bibbs said she’s mind-blown by the number of people she knows in the area who are sick. 

With information traveling farther and faster in the digital age, Bibbs wonders if that’s part of why she’s hearing more cancer stories now than she ever did when she was younger. But regardless of why, she believes “there has to be something” driving it.

“The correlation of the amount of people that are sick in this area with pancreatic and colon cancer … You almost can’t fathom it,” she said. 

By supporting nearby friends with cancer and coming to terms with her own diagnosis, Bibbs has become deeply involved in the area’s “cancer community.” When you’re going through something like this, you become paired with the most unlikely people, she said.

Bibbs and 27-year-old Kennett resident Andrew Brown are one such pairing. “Brown was diagnosed with cancer in 2023, after learning that a nearly 2-year-old spot on his pancreas, which doctors originally identified as a cyst, was actually a tumor.”

After genetic testing, Brown found out he has a genetic mutation called Lynch syndrome, which can increase the risk of developing cancer before the age of 50.

Bibbs has grown close to Brown and his partner, Megan Williams, over the past few years. Bibbs is a big believer in the notion that “people need people,” and in a close-knit area like theirs, so many are willing to drop everything and help.

In Kennett, where the only hospital in town has been closed since 2018, Bibbs said “you rely on your medical friends” for support. 

“I wouldn’t know the things I know, if it wouldn’t be for me having such a close-knit community, and having so many close friends that have medical backgrounds and knowledge,” she said. “Being from a small town right now is saving my life.”

The connections Bibbs has forged in the Bootheel are incredibly sustaining. But at the same time, the lack of immediate health care access in her area doesn’t always feel sustainable for many in the community.

‘Everything’s a drive’

About an hour away from Kennett, David Wyman, the city administrator of Dexter, is cautiously eyeing the rates of diseases like cancer.

“That’s always something that we’re concerned about,” Wyman said. “I don’t know that it is restricted to just our part of the state; even that just seems like something that is becoming more prevalent, even nationwide.”

Dexter is the largest community in Stoddard County, housing a bustling suburban/rural mix of approximately 12,000 people — about 8,000 within city limits and 4,000 just outside, according to Wyman. It’s also where Bibbs goes for care.

“We are pretty blessed, considering our rural nature and the size of our community,” Wyman said, acknowledging Dexter’s urgent care services and the presence of Mercy Hospital Stoddard in Dexter. As a rural hospital, it can’t perform all functions, but it does have a 24-hour emergency room and a rotation of specialty doctors.

Bibbs, who moved from Kennett to Poplar Bluff in October 2023, goes to Mercy in Dexter for some of her oncology treatments.

“I’m thankful because there’s a hospital in Poplar Bluff … but everything’s a drive,” she said. “Everything’s a drive, and of course, it’s expensive.”

Ryan typically drives Bibbsi to and from appointments. But not everyone has a Ryan — and not everyone has the luxury of accessible health care.

Twenty-one hospitals have closed in Missouri since 2014, according to Missouri Hospital Association data from October 2024, including Kennett’s former hospital, Twin Rivers Regional Medical Center.

“The lack of health care, period, in this area is poor, horribly poor,” said Cheryl Bruce, executive director of the Dunklin/Stoddard County Caring Council. “Doesn’t matter if you need to go to the foot doctor or the ear doctor, and then back to cancer treatments. You’ve got to drive.”

The Dunklin/Stoddard Caring Council, based in Kennett, provides transportation assistance to county residents in need of cancer care. When Kennett’s hospital closed, it left not just the city, but the entire county without a hospital, stripping the region of critical health care infrastructure.

As a result, Kennett residents often travel to Cape Girardeau or Jonesboro, Arkansas, for medical care — drives that can take anywhere from one hour to an hour and a half.

Brown has traveled from Kennett to Dexter for medical care once a week for nearly two years now. Some aspects of his treatment require an even longer drive to Cape Girardeau: procedures, scans and sometimes, emergencies where time is of the essence.  

“There was one instance where he had an infection set up after a procedure, and his temperature was through the roof,” Williams said. “It was climbing steadily with medicine not helping at all, and so getting him to Cape quickly was pretty scary. Definitely would have loved to have something much closer.” 

Bibbs’ own medical treatments pull her in different directions, too. For some general treatments, it’s a drive to Cape Girardeau. For surgeries, it’s a trip north to St. Louis.

“You’re just everywhere,” she said. “You kind of have to drive everywhere because we don’t have a large enough facility in one area to do all of it.” 

‘Dancing Queen’

For Bibbs, the 45-minute drive to the hospital in Dexter for treatment can be a daunting one. Her mind is “always going 100 miles an hour,” and if she’s not careful, it’ll wander to the worst places.

“You gotta pump yourself up, you gotta get yourself ready,” she said.

To escape her own thoughts, Bibbs often turns to music. One of her favorites? ABBA’s “Dancing Queen.” She came across the song in a TikTok video remembering a woman who had died from cancer. Ever since, she hears the song randomly. In the store, on shuffled playlists — everywhere.

“My fight song, I guess,” Bibbs said. “Put on some music and dance it out. Sing it out, dance it out, scream it out, whatever.”

Even after new rounds of treatment, Bibbs said she tries to navigate her life as though cancer isn’t part of it. She finds power in how she presents herself to the world, which is often in full glam and dressed to the nines. Sickness doesn’t dare supersede her style.

“If you know me, you know I’m not going to go out looking as bad as I feel if I can help it,” she said in a TikTok.

Bibbs learned this from watching her nanny (grandmother), who shares her name. She held herself to a high standard, even while living with multiple sclerosis. 

“She always put herself together,” Bibbs said. “That’s probably where I got a lot of my grit from, because I saw her, my whole life, struggle, like have to really make herself get up … She was so strong, always.” 

Alongside Bibbs’ chic outfits and gleaming jewelry, she also wears a collection of more permanent accessories — her tattoos.  

“Why not decorate yourself, make yourself pretty, if that’s what you want to do, you know?” she said. Even her bad tattoos, she explains with a laugh, hold meaning for her. 

The art etched onto her skin, whether it’s a tiny rocket or a set of guitar strings, is a testament to who she is, and the people she loves most. The mantra “be still” rests on her arm, while designs for each of her children speckle her arms and torso. 

A mother of three, Bibbs said her kids are why she fights so hard every day. They’re her support — her life. 

“A lot of people, when you’re handed this, your immediate thought is ‘I’m going to die,’” she said. “When I look at my children, I think, ‘No, that’s why I want to live. I’m going to live — for them.’”

Her oldest is 26; he’s her tough one, taking her treatment updates in stride and sending strength to his mother in spades. Bibbs’ daughters, 11 and 16, respectively, are her spitting images. She’s thankful that her 11-year-old is “just young enough to kind of not get it enough,” while her wish for her 16-year-old is for her to simply be a teenager.

“I don’t want her worried about me and sick for me and sad for me — I want her to be a teenager,” Bibbs said. “I want her to live and kick and scream and scratch and claw and do all the things.”

Through genetic testing, she confirmed that her children didn’t inherit an increased risk for her specific type of cancer. Despite that semblance of relief, she acknowledges that early health screenings will still be important for them.

“I want them to know if (cancer) ever is laid on their doorstep, that they can kick its ass, just like I can,” Bibbs said. 

Just like her family, Bibbs’ Bootheel community immediately came to her defense after her diagnosis. If she’s ever in a funk, she said her friends will always come calling. 

“If I’m having a bad day, I can have a bad day — but I’m not going to have a bad week,” she said. “Because they’re going to make dang sure that I don’t … And that is one of the biggest blessings.” 

Reporters Alex Cox and Xander Lundblad contributed to this story.

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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.

The post A cancer fight in rural Missouri: ‘Being from a small town right now is saving my life.’ appeared first on Investigate Midwest.

Unyielding is a University of Missouri School of Journalism project for Investigate Midwest.

It’s been more than three years since the closure of Audrain Community Hospital, ending more than a century of continuous local care in Mexico, Missouri.

Once a cornerstone of rural health in the region and the first community cancer center in the state, the hospital shuttered in March 2022 after a series of management failures under Noble Health and its successor, Platinum Health. For the thousands who relied on it, the closure didn’t just change where they went for care, it changed the very rhythm of their lives.

This same story has played out in rural counties throughout Missouri and the Midwest. Twenty-one hospitals have closed in Missouri in the past 10 years, many in rural areas. Residents now must drive long distances for care, or make the decision that it’s just not worth traveling until the pain is too great or the symptoms too strong to ignore.

No one knows that better than Joseph Corrado.

Corrado spent more than 40 years operating at Audrain. Now, he spends his time on the road, driving to Columbia three days a week, and to Jefferson City another two. His 2016 Cadillac Escalade, once a means of local commuting, has logged more than 6,000 miles this year alone.

“Well, I mean, as a surgeon, it’s very, very difficult to not have a hospital,” Corrado said. “I can’t, you know, do your operation in the garage.”

Corrado used to roll out of bed and get to the operating room in three minutes, often finding he’d beat the ambulance there.

Before the closure, patients could see him in his Mexico office on Monday, and be on an operating table by Tuesday. Today, everything is more complicated and farther away.

But what was lost wasn’t just convenience, it was trust, built across generations. Corrado said most of his patients didn’t want to go elsewhere for care. They preferred seeing someone they knew, someone local. 

After more than four decades in Mexico, he had developed a bond not just with individuals, but with entire families, treating grandparents, parents and now their children. His medical charts, he noted, are “42 years thick.”

That kind of relationship made health care personal, Corrado said. “I can’t go to Walmart without my patients coming up to me in aisle five and telling me, ‘Oh doctor, look at my incision.’”

‘A five-minute appointment takes half a day’

Rural areas of the state have higher poverty rates and older demographics, and about one in four rural Missourians rely on Medicaid. With fewer patients using private insurance, it has become harder for rural hospitals to offset losses.

The unemployment rate also has grown in many rural areas with hospital closures, as these cities lose a major contributor to the local economy.  

For Elizabeth Berry, 72, and Randy Dickson, 63, not having a hospital means more than just not having a place to get the care you need. It adds another layer of difficulty when it comes to actually getting to the closest hospital, which, for most in the Mexico area, is about 40 miles away in Columbia.

“You pretty much know, if you have an emergency, you are in serious trouble,” Dickson said in an interview. “It’s a bad situation. And when you do get down there, it’s so crowded that you can’t get in. You have people who are being treated in the waiting area.”

These struggles impact everyone in the area, but the impact is greatest on people who are older, can’t drive or have health issues, and are on their own.

“The only way I can get there is in an ambulance, and I can’t afford it,” Dickson said. “So if I have an emergency, I just have to hope I don’t die before I get there.”

Berry’s husband died after years of battling kidney failure and heart issues. She is still struggling to pay off the debt that came with his medical bills, exacerbated by the lack of local care. 

“He had to be airlifted a number of times or had to take an ambulance because of his issues, and I am still dealing with the bills that are coming in for transportation,” Berry said. 

Patients sometimes live with injuries and illnesses for long stretches of time before seeking medical attention. Due to the high cost of emergency medical transportation, some people, when injured, wait for it to heal instead of immediately seeing a doctor. 

This has created a layer of caution for a lot of people in Mexico, knowing “they are only going to a hospital if it is ‘life or death,’”  Dickson said, adding “if we had an emergency room with some good doctors, that would be so much better.”

Angela and Steve Teeter travel weekly to Cape Girardeau for Steve to receive radiation and chemotherapy. He was diagnosed in early January with Stage 3B lung cancer, the disease having spread to his lymph nodes. On May 13, a spot was found on his brain, indicating the cancer had spread and leading to a Stage 4 diagnosis. The Teeters will need to drive an additional three and a half hours to St. Louis so he can receive radiation treatment. 

Angela walked through what a typical appointment looks like for Steve.

“He’s doing chemo now, and he goes weekly for the treatments every Friday, and they’re usually anywhere from, I would say, on a short day, probably five hours, and then on a long day, probably like seven hours,” Angela said. 

“Once we go in, we do a blood draw, then we wait, and then we see the doctor, and then we wait, and then we start the infusion. In a month and a half, we will (have traveled) back and forth about 30 times. It’s three hours there and back. So, you know, a five-minute appointment takes half a day.”

With no nearby hospital, his initial diagnosis was delayed. “There was a lot of sickness going around, you know, flu and stuff like that. And so he went to the doctor, and they gave him antibiotics and a steroid, and then it kept on,” she said.

“He kept coughing. And so he went back to the doctor a month or so later, and they did the same thing,” she said. But the coughing persisted, and she eventually brought him to urgent care to get an X-ray. “And then they found the tumor,” she said, “and sent him to the emergency room.”

By the completion of Steve’s weekly chemotherapy in June, the Teeters traveled an estimated distance of 13,400 miles.

‘Padlocks on the doors’

In Audrain County, the hospital’s decline began quietly in early 2020, after Noble Health acquired it. Under their tenure, and later that of Platinum Health, chaos seeped into every corner of the operation. Vendors weren’t paid. Employee health insurance was dropped, without notice. Scores of lawsuits mounted. 

“I’ll never forget the day they put the padlocks on the doors and said we’re closed,” Corrado, the surgeon, said. “What do you mean we’re closed?”

Now, emergency care in Mexico often starts with a race against time. Patients are stabilized by the local ambulance district and rushed to the nearest available emergency room, typically in Columbia, 40 minutes away. There they can face hours-long wait times.

A potential path forward has emerged. In October 2024, Mexico city officials signed a letter of intent with Boone Health, entering exclusive talks to bring a critical access hospital back to town. The proposed three-year plan outlines a Medicare-certified facility with emergency services and outpatient care. But for now, it’s just that — a plan.

Meanwhile, health care advocates warn the impact of a rural hospital closure goes far beyond emergency care. Heidi Lucas, executive director of the Missouri Rural Health Association, said the collapse of one service affects the entire system.

“In rural health — really in health care altogether — it’s very much a continuum of care,” Lucas said. “If you’re not addressing one section of it, it affects other portions. And you kind of have to look at all of them to move the needle in health care access.”

Lucas and others point to the fragile financial state of rural hospitals. COVID-era relief funds gave many a temporary cushion, but those funds have long since dried up. One rural CEO told her he was “making about $0.36 for every dollar I spend.”

Community Health Specialist Jennifer Eldridge of the University of Missouri extension program said the grant programs that once propped up rural health initiatives are vanishing, too.

“I’m sad about their future,” she said. “They do depend on a lot of the grants … that I’m guessing may not exist anymore.”

Eldridge recently attended a public health conference where some scheduled presenters never arrived. “They’d already lost their jobs,” she said.

For farming communities especially, preventive care is becoming harder and harder to access.

“You don’t really get a day off unless it rains,” Eldridge said. “And it’s hard to predict rain a month out.”

Some residents, she added, simply don’t want to go. “I’ve been sitting with my extension council and they’ve told me they know people who would rather stay on their farm and die than drive to the city for health care.”

For Corrado, the distance is not just a commute,  it’s a constant reminder of what his town lost.

“We had an excellent medical center,” he said. “We got all kinds of accolades and recognition and that’s all gone.”

As the community waits to see if Boone Health’s proposal will materialize, Corrado keeps driving. The miles pile up. The surgeries continue. And the absence of a hospital in Mexico remains a wound that hasn’t yet healed.

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Read the rest of the series.

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.

The post Long drives, longer waits and fading trust mark the new reality of rural health care appeared first on Investigate Midwest.

Unyielding is a University of Missouri School of Journalism project for Investigate Midwest.

KENNETT, MO. — Nestled in Missouri’s Bootheel is the small town of Kennett, the Dunklin County seat. With just over 10,000 residents, it’s a close-knit community where good-natured teasing is a common show of affection.

Once a sprawling swampland, it has since been transformed into an expanse of flat, fertile fields where agriculture stands as the backbone of the region’s economy.

Kennett’s houses don’t get much taller than one story, and as visitors stroll down the main street, they’re welcomed by a mix of restaurants, boutiques and a cozy hair salon. These buildings are dwarfed in size by a silent, boarded-up hospital, its vacancy a remembrance of what the community has lost.

It’s the kind of community where if something tragic happens, everyone finds out. 

Bobbi Bibbs found this out the hard way. She discovered she had cancer in her colon in December 2023, which then metastasized to her liver, making it a stage four diagnosis. 

Bibbs isn’t alone. Dunklin County is among the 10 counties with the highest rates of that type of cancer in the state. This isn’t just a statistic, Bibbs said she can see it and almost can’t fathom it. 

“There are so many (cases) where we are from,” Bibbs said. “Like, it’s got to be coming from somewhere.”

Bibbs is surrounded by people who understand her struggles, many of whom work in the agriculture industry. In Dunklin County, there are hundreds of thousands of acres of crops — and most of that land is blanketed by pesticides. 

Estimates suggest that thousands of kilograms of pesticides are sprayed over Missouri cropland each year. In some places, wastewater sludge containing “forever chemicals” — per- and polyfluoroalkyl substances — is applied on farmland as fertilizer.

Multiple scientific studies have explored a connection between pesticide use and cancer,  pointing to a silent public health crisis hitting rural communities particularly hard.

The University of Missouri, in partnership with Investigate Midwest, conducted a county-by-county analysis of cancer rates and pesticide use, using the most recently available data for pesticides that are repeatedly cited in research as likely to be associated with cancer risk.

The six counties with the highest use of these pesticides per square mile are all located in the Bootheel, including Dunklin. Four of those counties are in the top 15 for overall cancer rates in Missouri. All counties with the highest rates of cancer are rural.

So in Kennett, there are high rates of chemical usage, high rates of cancer — and the nearest trauma center in the state is more than an hour and a half away.

In other words, it’s a typical rural town in Missouri. 

Green hills and kilograms of chemicals

While Missouri has its share of rolling hills covered in trees and wild foliage, much of the land is well developed to suit the needs of farmers and their crops. There are about 27 million acres of Missouri farmland being cultivated and nearly 88,000 farms, according to the Rural Farm & Finance Policy Analysis Center. 

The biggest business in the state is agriculture, employing about 460,000 statewide, according to the Missouri Department of Agriculture. Soybeans, corn and wheat are some of the crops that color most of the state’s landscape. 

Farming is a dangerous job that requires a good deal of heavy equipment and specialized tools. Those tools include chemicals.

Isain Zapata is a data scientist who researched the relationship between pesticides and the incidence of cancer. He looked at the complex mixtures of pesticides tailored to specific crops that are sprayed in different regions. 

“When we look at those pesticides, it’s not just one — it’s all a cocktail,” Zapata said. “It’s the whole rainbow of different colors.” 

He found that these colorful combinations are strongly linked to certain cancer rates across the nation.

“Non-Hodgkin’s lymphoma and leukemias are very intimately associated with pesticide use,” Zapata said. “But we also saw that the overall pesticide use has an effect on all the other non-obvious cancers.”

Other research shows an association between certain pesticides and an increased risk of brain, prostate, breast, kidney and colon cancers.

Pesticides are a classification of substances used to protect crops. This includes killing weeds, insects or even strengthening wood to prevent pests from harming the plant. Farmers typically apply pesticides to crops using methods such as aerial spraying or ground-based equipment.

Serious risks are posed by pesticides because they can harm both human health and the environment. Exposure may lead to short-term or long-term health problems, while also contaminating soil and water, which may disrupt ecosystems and affect wildlife.

But pesticides do what they do best. Zapata emphasizes that without pesticides, agriculture-based economies and the communities tied to them would suffer.

“I am not in favor or against pesticides,” Zapata said. “I know we need them. I don’t like them, but I know why they have to be there.”

He said rural agricultural areas are home to an intense combination of factors that multiply the risk level.

Farmers are under pressure to maintain or increase their productivity, and that comes at the cost of using compounds that carry health risks, Zapata said. Rural areas are often underserved by health care facilities, meaning there are often too few health providers and resources in theose areas to monitor and manage the added risk of using pesticides.

“It’s just the perfect storm,” Zapata said. “You combine several factors (heavy pesticide usage, poor regulation and monitoring, socioeconomic disparities), you’ve made it worse.”

The million-acre highway

Mike Milam is a local expert in pesticide application. Based in Kennett, he is a field specialist in agriculture and environment for MU Extension, serving Dunklin, New Madrid and Pemiscot counties. 

“I’ve had people tell me, especially the ones who don’t like chemicals at all (that) our bodies weren’t designed to breathe these chemicals,” Milam said. “And they’re right about that.”

The herbicide Roundup is the target of thousands of lawsuits claiming it causes cancer, putting it in the spotlight. Milam listed other chemicals that have caused concern, including paraquat, vydate and dicamba.

Farmers and the workers hired to harvest crops frequently interact with chemicals. From mixing to pouring to spraying, they are there for all of it. They also encounter other farmers’ chemicals when a substance sprayed in one area drifts somewhere it was not intended to be. 

“I have known a situation (where) people out in the fields got sprayed, or they sprayed next to them, and then it drifted over. And things like that,” Milam said. “Matter of fact, when I was in graduate school, I was in a field down in Louisiana, and they were spraying right next to us. We actually had to leave the field.”

Direct drift occurs when an applicator applies a pesticide and the wind blows it elsewhere, making monitoring weather conditions an integral part of the process. The stronger the wind, the stronger the potential is for drift. 

That said, farmers have a limited window to seed and fertilize their fields during planting season. Fluctuating weather conditions can make this even more difficult. This spring alone, the Bootheel faced tornadoes, dust storms and historic flooding, all of which have the potential to hinder field work.

“We go out here, we can plant a crop, it looks beautiful, a flood wipes it out, and we gotta start back over,” said Sen. Jason Bean, R-Holcomb, a fifth-generation Bootheel farmer.

Milam said that some farmers end up spraying their crops when conditions aren’t ideal.

“The farmers aren’t paying attention or just decide to go ahead and (apply) anyway because they need to get it done,” Milam said. “They are under a lot of stress, they’re trying to get the crops in.”

Jason Mayer, a fourth-generation Bootheel farmer and one of the directors for the Missouri Soybean Association, believes that, nine times out of 10, farmers are doing the right thing. In his mind, it is the “bad actors” going against best practices. Bean compares this to speeding on the highway.

In his analogy, like drivers on the road minding the speed limit, most farmers follow the rules. Just as there will always be that driver blowing past everyone else in the left lane, there will be farmers who break the rules. 

Agricultural regulators — such as the Missouri Department of Agriculture or EPA — serve as the cop on the side of the road in the metaphor. They step in when misuse is suspected. Environmental Protection Agency inspectors can show up at any time and ask to see a farmer’s records, Milam said. 

With millions of acres of farmland in Missouri, that’s one big highway to watch. So if agencies don’t catch someone breaking the rules, it can fall to local farmers to report their neighbors to the state pesticide control office.

Bean emphasized that proper pesticide application isn’t just about compliance, it’s also in the farmer’s best interest. Misuse wastes costly chemicals, reduces crop effectiveness and decreases consumer trust in locally grown produce. 

“I’d say we’re great stewards of the land,” Bean said. “We’re going to continue that, because in the big picture, farmers want to produce for the world the safest, abundant product.”

Milam said the key is to use the chemicals appropriately to minimize exposure. He said wearing personal protective equipment during application is a best practice. So doing things like wearing long pants, long-sleeved shirts, masks and goggles is essential for safe use. 

Bean does not believe pesticides cause or increase the risk of cancer. Mayer echoes this sentiment, emphasizing his lifelong experience around crops and chemical applications.

“I’m 42 — knock on wood — today,” Mayer said. “I’m still relatively young, perfectly healthy, and I’ve been on the farm since I was 14.”

Waiting on a waiting room

Striking up a conversation about health care in Kennett is bound to lead to one topic: the hospital. 

Kennett doesn’t have one anymore; Twin Rivers Regional Medical Center closed its doors in 2018. 

For quick stitch-ups or infection treatment, St. Bernards Urgent Care is open every day. It closes at 7:30 p.m., meaning that Kennett residents have to go elsewhere for their nighttime care. 

There are various options in nearby counties, or even in neighboring states, but if someone needs emergency care, for example, it’s a trek. 

While there’s a Mercy Hospital located in nearby Dexter with a rotation of specialty doctors, the closest Missouri trauma center to Kennett is in Cape Girardeau, about an hour and a half away. 

“(If) I have a heart attack at eight o’clock at night, or stroke, and if (the urgent care) was still open, they could give me that little fancy pill and help get me to the hospital to help,” said Cheryl Bruce, the executive director of the Dunklin/Stoddard Caring Council, an organization based in Kennett offering an assistive services program to Dunklin County residents with cancer.

Kennett’s old hospital building is still standing on the town’s main drag. The windows are boarded up, and walking through the halls requires ducking wires and tiptoeing over glass shards.

The current owner is in a zoning battle to turn the hospital into something. They haven’t been able to find buyers yet because they need various approvals from the city to do any work to make the building sellable. 

Kennett isn’t alone in facing minimal health care access. Since 2014, 21 hospitals have shut down statewide, including 12 in rural areas, according to the Missouri Hospital Association. 

Additionally, the Center for Healthcare Quality and Payment Reform’s 2023-2024 report found 26 rural hospitals in Missouri are at risk of closure due to financial strain — nine of them are at an “immediate risk.” 

The Twin Rivers CEO said in a 2018 statement that the hospital’s closure was part of an effort to consolidate operations with Poplar Bluff Regional Medical Center, “as health care delivery evolves and medical innovation makes inpatient services less needed,.”  KFVS12 TV reported at the time.

It was a palpable loss for Kennett — people miss the hospital, Bruce said.

“When the hospital closed, all anybody has ever talked about is, ‘Are we going to get another one?’ ” Bruce said.

From 2020 to 2024, the Caring Council’s cancer assistive services program spent $22,650 helping over 400 people with transportation. For cancer care, folks in Kennett often travel an hour to Jonesboro, Arkansas, or an hour-and-a-half to Cape Girardeau in Missouri. Whatever kind of cancer care you need,, Bruce said, you’ve got to drive to get it.

The lack of health care providers also means early detection of medical issues, including cancer, can be harder to get.

Some health care transportation programs are available in rural areas, but Bruce said she sees a need in her community for more robust services. 

“I’m not asking for a bus system like in St. Louis or Kansas City or Jeff City,” Bruce said. “I’m just asking for access to care, whatever that means.”

Sprayed on all sides

Wherever you go in Kennett, there will be someone who’s called it home their whole life. Kennett’s City Clerk Jan McElwrath is one of those people. Aside from a brief stint at the University of Missouri, she’s spent nearly all of her 68 years in town. 

She came back for a classic reason: love. She got married, raised a family and built a life rooted in the same streets where she grew up. 

Over the decades, she’s seen businesses open and close, celebrated countless community milestones and weathered natural disasters. Through it all, McElwrath has observed one constant: despite differing beliefs and opinions, the people of Kennett always find a way to come together.

“Our strength is our people, hands down,” she said.

This is especially important when considering the unique challenges of rural living. 

An index created by the CDC shows that Dunklin is the county in Missouri least prepared to deal with economic or environmental challenges. According to Feeding America, over 20% of Dunklin County is food insecure, despite the fact that the region is covered in farmland. Milam said that this is largely because the farms in Dunklin are agronomic, which is when crops aren’t always grown for direct human consumption. 

“It would help a lot of people if they had fresh vegetables,” he explained.

As manufacturing jobs moved out of many places in the Bootheel, Kennett felt the economic sting. Though Cim-Tek Filtration’s arrival two years ago brought back some manufacturing jobs, Kennett lost its Emerson Motor Company plant in 2006.

One industry that remains is agriculture. 

The land is dotted with cotton, soybean and rice row crop operations. McElwrath calls the rows of cotton ready for picking “southern snow,” but to get that snow, farmers usually have to give plants a nudge with defoliants. 

Defoliation is a natural process, though it can be artificially induced when chemicals are applied to the plants to get them to open up, making the white cotton easier to harvest. 

McElwrath said it’s hard to notice farmers defoliating at first. But then, suddenly, your sinuses sting, your eyes burn, maybe a headache creeps in. It always seems to hit around the same time every year, right when the county fair is going on — with the dust, the dry soil, the demolition derby — everything blending together. 

It’s not just that the defoliants make things happen quicker; they help make the cotton a higher grade — that means there is less debris affecting the final product. The grade determines the value. 

Many residents of Kennett recognize the need for defoliants and other agricultural chemicals. For some of them, that’s what puts food on the table. But then the time of year creeps around again, and they all experience that familiar sensation. 

“We’re surrounded by agriculture,” McElwrath said. “We recognize (chemicals) as a risk, but our economy here is very dependent on agriculture.”

---

Read the rest of the series.

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.

The post The unseen harvest: Pesticides, cancer and rural Missouri’s health crisis appeared first on Investigate Midwest.

The divestment of staff, science and sustainability programs at USDA isn’t just a budget cut; it could be a direct threat to the nation’s food system. Experts warn of far-reaching consequences: unsafe food for consumers, more invasive and economically damaging pests for farmers, and an agriculture industry forced to adapt to climate change with less scientific insight.

“We might see more farming in the dark, essentially,” said Michal Happ, a climate change and rural community expert at the Institute for Agriculture and Trade Policy.

Investigate Midwest spoke with multiple agricultural experts and more than 30 current and former USDA employees to better understand Rollins’ leadership style, her impact on the department and the profound consequences her administration will have for farmers, rural families and consumers.

What emerged was a picture of a leader who has brought sweeping changes and largely embraced President Trump’s agenda of downsizing the federal government. However, Rollins has also been tasked with managing Trump policies that she has privately rebuked and cuts made before she assumed office.

Trump tapped Rollins to head the massive federal department at a crucial time for American agriculture. Farmers are grappling with changing weather patterns, shifting trade policies, and even internal administration critiques of pesticide use — a report from Health Secretary Robert Kennedy Jr.’s “Make America Healthy Again” commission, which Rollins applauded, slammed farms’ pesticide reliance.

Trump has praised Rollins’ performance. In mid-April, as an aside during a press conference, Trump thanked her for lowering egg prices. “Brooke Rollins, secretary of agriculture, did a great job,” he said. During his first term, she maneuvered into his inner circle and, as Politico reported, has quickly become “one of the most powerful conservatives in the country.” 

Rollins has said her mission is to be the voice of farmers in Trump’s cabinet. She appears to have pull with the president, but questions remain about her influence over decisions affecting the USDA and its staff.

Elon Musk’s Department of Government Efficiency, or DOGE, appeared to wield significant control over department operations, at least until recently. It influenced everything from policy language to which USDA offices remain open, according to court records and Rollins’ hearing testimony.

In a statement to Investigate Midwest, the USDA rejected any characterization that Rollins was not solely responsible for department actions.

“The claims you cite are absurd and without merit,” it said. “Secretary Rollins was appointed by President Trump to lead the Department and to insinuate that anyone other than the Constitutionally directed cabinet officer is making the decisions at USDA is unwarranted.”

She’s also been sandwiched between Trump’s signature policy, an extreme stance on immigration, and the reality of agriculture’s labor force.

“We might see more farming in the dark, essentially.”

Michal Happ, a climate change and rural community expert at the Institute for Agriculture and Trade Policy

Because of immigration raids, some farms’ labor pools have been depleted, and, already, some fields have not been harvested. Farmers have pleaded for relief. In early June, Rollins pushed Trump to pause enforcement on farms, The New York Times reported. After the news broke, Rollins proclaimed she was in lockstep with Trump.

Raids on farms resumed days later, but Trump recently expressed support for giving farmers discretion over undocumented workers.

“Brooke Rollins brought it up, and she said, ‘So, we have a little problem. The farmers are losing a lot of people,’ and we figured it out, and we have some great stuff being written,” he said during a July 4 speech. 

On July 8, Rollins said undocumented farmworkers would receive “no amnesty.”

Farming is inherently risky. Making a living depends on good weather and profitable markets. Farmers try to limit variables, but Rollins’ first months have added disorder into the food system, said Mike Lavender, a policy expert for the National Sustainable Agriculture Coalition.

“All of it is this theme of creating needless uncertainty and confusion amongst people who are trying to do the exact opposite in order to be successful in their livelihoods, support their families and ultimately support their communities,” he said.

The USDA did not directly answer questions about Rollins’ tenure, and, in a statement, it said she was cleaning up a mess left by her predecessor, Tom Vilsack.

“Secretary Rollins is working to reorient USDA to put Farmers First and be more effective and efficient at serving the American people,” the department said. “President Biden and Secretary Vilsack left USDA in complete disarray, including hiring thousands of employees with no sustainable way to pay them.”

In congressional hearings, Rollins said the USDA, which has lost more than 15,000 employees, has enough staff to fulfill its mission. Trump’s desire to make new deals with trading partners — which is causing confusion and financial anxiety for farmers — will create stability for agricultural producers, Rollins has said.

“I do believe, with every fiber of my being, that this era of unlimited or unprecedented prosperity for the ag community is just around the corner,” Rollins told Congress in June. “I’m just really, really sure of that.”

Rollins has painted the present as being “strikingly similar” to the time of the American Revolution, a period she often invokes in speeches. She has also cast her leadership in Biblical terms, citing Romans 13:12, saying she wears an “armor of light” in her current position. 

“There is just a lot of darkness — not with this White House or my current boss, President Trump, or our cabinet, but the government in general,” Rollins told Decision Magazine, a religious publication, during an interview last month. 

The USDA did not answer when asked if Rollins views rank-and-file employees as part of the “darkness.” But her management of employees varies drastically from her two predecessors, Vilsack and Sonny Perdue, Trump’s first agriculture secretary.

Perdue was a veterinarian and, as governor of Georgia, had led a large bureaucracy, experience that translated into running a complex federal department in a “thoughtful, analytical way,” said Kevin Shea, a USDA employee for 45 years under Republican and Democrat administrations. 

“The first Trump administration at USDA was run very professionally,” Shea said. Now, however, “the USDA political leadership seems to be particularly scornful of its career workforce.”

For instance, very little information filters down to employees. Leadership has not effectively communicated what it wants, so it’s been a “gradual process of learning what is and is not OK,” said Ethan Roberts, president of AFGE Local 3247, a union representing government employees, and a nine-year USDA employee.

Agency staff used to plan months or years ahead, but that’s difficult now because they don’t know if they’ll still have jobs or if the office will exist, said one current employee who requested anonymity for fear of reprisal.

Her two predecessors regularly sent department-wide emails that communicated their goals and priorities, current and former employees said. Rollins seems to have a different audience in mind.

“She just posts on X what she’s doing,” said Laura Dodson, the vice president of AFGE Local 3403 and a longtime USDA employee. X, the social media company owned by Musk, requires an account to view posts. “It just seems everything’s coming from DOGE and whatever the White House is saying about federal employees.”

The first Trump administration also instituted funding freezes and reduced staff, including relocating USDA offices out of Washington, D.C. One of the affected agencies was the Economic Research Service, which provides insights into markets the industry relies on.

In 2019, Dodson and her colleagues were called into a conference room. If their job description was called, they would remain where they had established their lives. The others, the vast majority, would be relocated to Kansas City, Missouri. Employees started crying.

Despite that episode from Trump’s first term, Dodson said, the tone of his second stint is markedly different as DOGE, overseen by Musk until May, has wantonly carved up federal agencies.

“They still maintained a veneer of respectability. They were trying to do this for the greater good,” she said about the USDA under Perdue. “Now, with people like Elon Musk, it’s clear this is not the pursuit of efficiency. It’s the pursuit of cruelty.”

For instance, school nutrition researchers were told to flag any studies that included the word “class” — an attempt to discover funding for diversity, equity and inclusion, a Trump target, said one employee who asked for anonymity for fear of reprisal.

Another time, DOGE’s main liaison to the USDA, Gavin Kliger, requested that the word “tracking” be added to the list of words to flag in grants that could be terminated, according to an email included in a lawsuit.

“Tracking the exact carbon output of soybean yields does not provide a direct benefit to farmers,” he reasoned in an email to staff, “and we can reallocate that funding in a way that more directly benefits farmers.”

Kliger’s LinkedIn resume does not show any experience in agriculture. He graduated from the University of California-Berkeley in 2020 and has worked exclusively for tech and artificial intelligence companies. He has helped slash staff and funding at other agencies, including the Consumer Financial Protection Bureau.

It’s unclear how he came to this understanding about carbon tracking.

Carbon is essential to soil health, producing higher yields. Knowing how much carbon is escaping their soil can help farmers adopt better soil management techniques. This not only helps farmers grow more efficiently but helps keep the plant from warming. Soy industry groups have expressed the importance of tracking carbon footprints.

Also, under a Biden-era rule, measuring carbon output helps put money directly in farmers’ pockets — they can sell their output on carbon offset markets.

Despite this misguided reasoning, Kliger appears to have had considerable influence at the USDA.

In the same email, he said he wanted to surpass DOGE’s goal of cutting $120 million in climate-focused grants by a certain date. “I spoke with the Secretary tonight who was supportive of these initiatives – working on getting a memo formalized for her signature in parallel,” he wrote.

Kliger did not respond to requests for comment to his USDA email address. The USDA did not respond when asked about the email or how much influence Kliger had.

“All decisions made at the USDA are at the direction of secretary Rollins to best fulfil (sic) president trumps (sic) agenda,” the department said.

Kliger appears to have moved on. The USDA said his access to the National Finance Center, which manages employee payroll, has been “deactivated due to lack of use. … We would refer you to” the Small Business Administration.

While voices with no agricultural experience have been elevated, those with expertise — USDA employees — have been pushed aside and silenced, current and former employees said.

One skirmish between DOGE and the USDA’s rank-and-file has involved the Trump administration’s return-to-office policies. Some Republican leaders and Musk have claimed that allowing employees to work remotely is a waste.

In 2020, the COVID-19 pandemic forced remote work for staffers at the Farm Service Agency, which helps farmers access federal funding. As the year progressed, Perdue, the agriculture secretary at the time, considered calling workers back to the office.

However, an internal study found that employees had actually been more efficient, said Charles Dodson, a 30-year FSA veteran who retired late last year.

Despite that, Trump ordered remote workers back to offices when he retook the presidency. At the same time, DOGE began canceling leases of local offices around the country.

At a May hearing, members of Congress accused Rollins of being unaware that local FSA offices were being closed. Rollins did not deny the accusation. Then at a June hearing, she said the General Services Administration, a DOGE target, was behind the closures. (Some offices have since reopened.)

On the ground, the situation has caused confusion and consternation for USDA employees.

When one employee reported to a new office, they were told they weren’t on the list of transfers. How could they follow the order to report to an office if they weren’t allowed in? Another USDA employee, a researcher, was ordered to report to a Forest Service trailer in the woods. And another employee, according to NPR, was told to report to a shed where a boat was stored.

The USDA has also intimidated its workforce, current and former employees said.

According to Roberts, the department veteran and union representative, USDA scientists have been instructed to deflect questions from university researchers — their frequent collaborators — about the agency’s internal affairs.

“They’re being told to say those things for fear it looks like the USDA is silencing them,” he said, “which they are.”

Surveillance also has increased. While the government has used software to monitor employee emails for years, the Trump administration has altered it to detect emails sent to a personal or college account. As part of a leak investigation, one staffer was placed on administrative leave after emailing their personal account, even though it did not contain the leaked material officials were looking for.

The USDA did not respond to a question about the leak investigation.

Some employees have responded by doing only what is asked of them, not going above and beyond. Dodson, the retiree, recounted what a current staffer told him: “I’m afraid to do anything else. I just want to survive and not get fired.”

The lack of staff is a major obstacle, Shea said.

“There couldn’t be a worse time to lower our guard,” he said. “APHIS cannot do its job with that level of personnel. It simply cannot do it. I’ve never been more concerned about the agency’s ability to carry out its mission going forward.”

The USDA has implemented a hiring freeze, but in April it exempted APHIS. The agency has posted job listings online.

“Secretary Rollins will not compromise the critical work of the Department,” the USDA said. The exempted positions “carry out functions that are critical to the safety and security of the American people, our national forests, the inspection and safety of the Nation’s agriculture and food supply system.”

Another challenge Rollins has faced is trade, the lifeblood of U.S. agriculture. 

When Trump returned to office, he generated chaos in the agricultural markets by starting a trade war and implementing higher tariffs. In response, Rollins has embarked on a global tour to establish new trade partners.

She has announced a few “Make Agriculture Great Again trade wins.” She recently proclaimed that Namibia, an African country, agreed to accept frozen poultry from the U.S. The Biden administration had opened the market after allaying the country’s concerns about bird flu. Also, she declared Costa Rica accepting U.S. dairy a win for Trump. An industry trade group said the “win has been several years in the making.”

Rollins has said repeatedly that the agricultural trade deficit — the U.S. imports more products from overseas than it exports — is bad for the country. The tariffs were intended to address the deficit, but the narrative hit a snag in early June.

Politico reported the USDA had delayed a regularly scheduled report because it showed Trump’s tariffs could exacerbate the trade deficit. Days later, Rollins defended the delay. “I want to be sure every piece of research we move out is the best, the best-cited, etc.,” she told Congress. (The hearing was about a week after news broke that the MAHA report, which Rollins supported, cited nonexistent studies.)

Perhaps the most pressing issue facing Rollins is helping the agriculture industry as it grapples with climate change, which is altering how farmers grow food and commodities. Rollins, however, has denied the planet is warming.

Her husband is an executive at an oil and gas company, and in a 2018 speech, she said “research of CO2 being a pollutant is just not valid,” according to Inside Climate News. More recently, she led the America First Policy Institute, which pushes Trump’s agenda. She employed another Trump loyalist, Carla Sands, who once said the idea of climate change is “Marxism to control humanity,” according to Politico.

In January, before Rollins was sworn in, USDA employees were directed to “unpublish any landing pages (on the USDA’s website) focused on climate change,” according to court records. Research involving climate change has also been effectively banned, current employees said. If studies include words such as “climate,” “clean energy,” “sustainable construction” or dozens of others, the research will not be funded.

Climate change is having profound effects on agriculture. For instance, the Corn Belt — considered the prime region for growing the valuable commodity used in everything from soft drinks to gasoline — is inching northward. In decades, instead of Iowa and Illinois, Minnesota and the Dakotas could be America’s breadbasket, researchers have predicted.

More recent research shows that, as the world keeps warming and farming gets harder, U.S. corn production could fall by 40% by century’s end.

If the USDA ignores climate issues, farmers could be struggling alone, said Happ, of the Institute for Agriculture and Trade Policy.

“They want to adapt to what’s going on,” he said. “They want to still have their land there and steward it for the next generation or two. Without those resources, they’re going to just have to figure it out on their own.”

The USDA did not respond when asked about Rollins’ household’s financial stake in fossil fuels. At a congressional hearing, Rollins agreed with a representative who said sound policy follows sound science. The USDA did not respond when asked why the USDA was not following climate change science.

The USDA has forced out 98 of 167 food safety scientists at the Agricultural Research Service, a department arm that studies how to prevent deadly pathogens, such as E. coli or Salmonella, from entering the food supply.

Foodborne illnesses could become more prevalent because the work the scientists were doing will likely just end, said Roberts, the union representative who works for the Agricultural Research Service.

“Who knows what we’ve lost? What discoveries or products that were going to be invented that we’ll just never see?” Roberts said. “We’ll be stuck with the tools we have now.”

A robust food safety system, with research and vigilant monitoring, is necessary to help prevent foodborne illnesses, which not only can hospitalize consumers but also have long-lasting health consequences, said Barbara Kowalcyk, a longtime food safety researcher who is now at George Washington University. In a 2013 study, Kowalcyk and her colleagues showed foodborne infections could lead to, among other conditions, chronic kidney disease, arthritis and cognitive deficits.

An example of science and government oversight working in concert to save lives stems from a deadly outbreak in the 1990s, she said. After eating undercooked hamburgers at Jack in the Box, more than 700 people fell ill and four children died. 

The scandal put the USDA’s food safety system under an intense microscope, and the department changed how it protected America’s meat supply. Instead of eyeing and smelling a carcass, the USDA began testing for pathogens, a monumental task to implement.

The original testing procedure was first developed in the 1960s and refined over the decades. Since the USDA’s Food Safety and Inspection Service began using the system — named Hazard Analysis and Critical Control Point — cases of foodborne illness from beef have declined dramatically.

“Lots of effort went into that,” Kowalcyk said. “We don’t see the same level of outbreaks in ground beef that we used to.”

Rollins plans on altering the USDA’s, and the country’s, future through her actions. Cutting funding to farmers, axing scientists, instilling fear in remaining employees — it’s about changing the country’s course.  

“It isn’t just about the next four years,” she told Breitbart in May. “It’s about the next 250 years.”

But it could all backfire on farmers, rural communities and consumers, said Lavender, with the national sustainable agriculture coalition.

“The draining of expertise at USDA,” he said, “whether that’s scientific expertise or just expertise of people who have been there for a period of time and have built up knowledge —  it will ultimately come home to roost.”

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The post ‘Farming in the dark’: Brooke Rollins’ leadership, DOGE’s grip and the cost to American agriculture appeared first on Investigate Midwest.

This article draws from the author’s research for her book Landscapes of Care: Immigration and Health in Rural America, which examines health care in rural immigrant communities on Maryland’s Eastern Shore. (Read Barn Raiser’s interview with the author here and an excerpt of the book here).

Over the next six months, Barn Raiser will publish a six-part series on rural immigrant experiences. Upcoming articles will explore the women who work in Maryland’s crab industry, how rural providers make do with “Band-Aid care,” racialized exclusion in health care access and how networks of resistance and mutual aid sustain immigrant communities.

W[dropcap]hen we talk about immigration in America, the conversation almost inevitably centers on one question: Are they here legally or illegally? This binary framework shapes everything from policy debates to health care delivery, often reducing complex human experiences to a simple legal category.

My ethnographic research over 10 years, from 2013-2023, on Maryland’s Eastern Shore reveals how this legal/illegal binary is not only inadequate but actively harmful to understanding the realities of immigrant life in rural America, particularly when it comes to health care access and community belonging.

In order to move beyond this reductive framework, we need new ways to understand both the challenges immigrants face and the resilience they demonstrate in navigating systems designed to exclude them.

The limits of legal categories

During my fieldwork, I encountered Lud, a Haitian migrant worker who had been traveling from Florida to Maryland for 13 years to pick and pack tomatoes. When a local health organization arranged breast cancer screenings for “migrant women,” Lud witnessed something that crystallized the problems with how we categorize immigrants.

The health care workers proceeded to screen only Latina women, refusing to allow Haitian women to participate. When questioned, they stated that Haitians didn’t meet the inclusion criteria for the screening—not because of their legal status, but because they didn’t fit the workers’ conception of what a “migrant” looked like. In their minds, being Black somehow disqualified these women from the category of “migrant worker,” despite sharing identical migration patterns, working conditions and labor trajectories with their Latina counterparts.

The legal/illegal framework inevitably creates hierarchies of deservingness that obscure shared conditions and interests.

This incident reveals how racialization operates alongside and sometimes independently of legal status to determine who receives care and recognition. The Haitian women weren’t excluded because they lacked proper documentation—they were excluded because anti-Black racism rendered them invisible within the very category designed to serve migrant workers.

When documentation doesn’t guarantee access

The focus on legal status as the primary barrier to health care access misses how other forms of exclusion operate. I met documented immigrants who still faced significant barriers to care due to language, cost, transportation and provider bias. Conversely, some undocumented immigrants had developed sophisticated networks of support that provided them with better care than some of their documented counterparts.

Consider María, who arrived on a valid H-2B visa to work in crab processing. Despite her legal status, she struggled to access specialty care for a chronic condition because:

• The nearest specialist was 120 miles away
• Her employer-sponsored insurance had high deductibles she couldn’t afford
• No providers in her area spoke Spanish
• Taking time off for medical appointments jeopardized her seasonal employment

Meanwhile, Ana, who was undocumented, had developed a relationship with a nurse practitioner who worked on a barter system. Ana received comprehensive family care in exchange for the tamales she made, creating a relationship that extended far beyond a simple service transaction.

These examples illustrate how legal status alone doesn’t determine access to care. Instead, a complex web of factors—including race, language, geography, economic resources and social connections—shapes immigrant experiences with health care systems.

The complexity of temporal status

Rural immigrants often exist in states of temporal uncertainty that don’t fit neatly into legal/illegal categories. Temporary Protected Status (TPS) recipients—such as immigrants from Haiti, Afghanistan and Somalia, among others—live with the constant possibility that their protection could be revoked. This fear has only been heightened by the U.S. Supreme Court’s May 19 decision to uphold the Trump administration’s attempt to end TPS for Venezuelans. (On July 1, a federal judge blocked the administration’s attempt to end TPS for Haitians). Seasonal workers on H-2A and H-2B visas face annual uncertainty about whether they’ll be selected in future years for the limited number of available positions.

Robert and Esther, a Haitian couple with TPS status, found themselves in a bureaucratic limbo when it came to health care. They were legally authorized to work and live in the United States, but their temporary status made them ineligible for many forms of public assistance. The high cost of health insurance under the Affordable Care Act meant they chose to remain uninsured and pay annual penalties rather than purchase coverage they couldn’t afford.

“I will wait for another government,” Esther told me in 2015, referring to her hope that future political changes might create better options. “They have got to change that.”

This temporal precarity—the sense of living in an extended present without clear futures—affects immigrants regardless of their current legal status. It shapes how they make decisions about health care, where they establish roots and how they understand their place in American communities.

Race and the politics of inclusion

Perhaps most significantly, the legal/illegal framework obscures how race determines which immigrants are seen as deserving of care and belonging. Throughout my fieldwork, I observed how anti-Black racism marginalized Haitian immigrants, who shared similar legal statuses with other immigrant groups.

Haitian workers often faced different treatment than their Latino counterparts in poultry plants, with supervisors quick to dismiss their concerns or fire them for minor infractions. When Haitian communities sought health care services, they found fewer interpreters, less culturally appropriate care and lower levels of provider understanding about their specific needs and experiences.

This differential treatment wasn’t based on legal status—it was based on how Blackness is perceived and devalued in American society, including in rural areas like Maryland’s Eastern Shore where racial hierarchies date back to the slave trade (Maryland was a slave state until 1864, when it was abolished by the passage of the Maryland Constitution).

Junior, a young Haitian man who worked in a poultry processing plant, described how learning English became an act of resistance against these racial hierarchies: “I think that the first time I said ‘no’ is the first time things started to get better. I remember all of the guys in the line started treating me different because I can talk to them now.” For him learning English became a tool for asserting dignity and humanity within a system designed to render him voiceless—a dynamic that extends far beyond questions of legal documentation.

Yet just as racial hierarchies have deep historical roots in the area, so too do movements of resistance. The Eastern Shore has long been a site where marginalized communities have created networks of survival and mutual aid despite—and because of—systemic exclusion. Harriet Tubman, born into slavery just miles from where today’s immigrant workers labor, conducted numerous missions through this region as part of the Underground Railroad, helping enslaved people escape to freedom. During the 1960s, Cambridge, Maryland, became an epicenter of the civil rights movement under Gloria Richardson’s leadership, with the Cambridge Nonviolent Action Committee challenging racial segregation and economic inequality.

Today’s immigrant communities continue this legacy of resistance, though their strategies necessarily differ. Like Tubman’s carefully planned routes that relied on trusted networks and intimate knowledge of local terrain, contemporary immigrants create what I call “landscapes of care”—informal systems of mutual support that operate outside official channels. When Junior learned to say “no” in English, when Haitian workers organized to challenge exclusionary health screenings, when Mexican women developed collective strategies to access medical care during limited clinic hours, they were engaging in acts of resistance that echo the Eastern Shore’s longer history of people refusing the logic of their own disposability.

This historical continuity reveals how resistance emerges not just from individual agency but from the collective knowledge that survival requires building alternative systems when official ones fail to recognize your full humanity.

Structural vulnerabilities beyond status

As the examples above illustrate, moving beyond the legal/illegal framework allows us to see how structural vulnerabilities operate across multiple dimensions. Rural immigrants face:

Geographic isolation: Living in remote areas with limited transportation options and significant distances to services.

Economic precarity: Working in low-wage, often dangerous jobs with minimal benefits and high injury rates.

Social marginalization: Existing in communities where they may be economically essential but socially unwelcome.

Linguistic barriers: Navigating systems designed primarily for English speakers.

Racial discrimination: Facing different treatment based on how their bodies and identities are racialized.

Temporal uncertainty: Living with the constant possibility of economic, legal or personal disruption.

These vulnerabilities intersect in ways that don’t depend solely on documentation status. An undocumented Mexican woman, a Haitian man with TPS and a H-2B visa holder might face entirely different challenges despite sharing rural geographic spaces.

Beyond deserving and undeserving

The legal/illegal framework inevitably creates hierarchies of deservingness that obscure shared conditions and interests. It suggests that people with proper documentation deserve care and support while those without it do not. This logic not only ignores how legal status can change rapidly due to policy shifts or bureaucratic errors, it also implies that human worth is determined by state recognition.

Rural health care providers I interviewed often struggled with these imposed categories. David, a physician who treats many immigrant patients, expressed his frustration: “If you are poor, there are patient assistance programs through the pharmaceutical company, but if you’re undocumented, you are nothing.”

The reduction of human beings to “nothing” based on legal status represents a profound ethical failure. It also ignores that fact that these same individuals contribute labor, taxes, community participation and cultural richness to rural areas that depend on their presence.

Alternative frameworks

What emerges when we move beyond legal status is a more nuanced understanding of how immigrants navigate rural America. Rather than passive victims of policy or grateful recipients of services, we see people making strategic decisions within constrained circumstances, creating networks of mutual support and developing sophisticated knowledge about how to survive and sometimes thrive in challenging environments.

This perspective highlights:

Agency within constraint: How immigrants make strategic decisions about work, health and community participation despite limited options.

Knowledge production: How immigrant communities develop expertise about navigating rural systems that formal institutions often lack.

Mutual aid: How immigrants create support networks that operate independently of formal services.

Cultural contributions: How immigrants reshape rural communities through their presence, labor and social participation.

Resistance practices: How immigrants challenge exclusionary systems through everyday acts of refusal and assertion.

Implications for rural health care

For health care providers and systems serving rural immigrant communities, moving beyond legal status opens up new possibilities for care delivery. Rather than asking “Are they here legally?” providers might ask:

• What barriers to care does this person face?
• How can we design services that are accessible across different forms of vulnerability?
• What strengths and knowledge does this community bring that could inform our approach?
• How can we create care relationships that recognize people’s full humanity?

This shift requires developing what I call “structural competence”—the ability to recognize and address the structural conditions that shape health outcomes, rather than focusing solely on individual behaviors or legal categories.

Toward more complex narratives

Rural America is changing rapidly, and immigrants are central to that transformation. Rather than viewing this change through the narrow lens of legal/illegal status, we need frameworks that capture the complexity of how people create lives and communities under challenging circumstances.

The stories I’ve shared from Maryland’s Eastern Shore reveal immigrants as complex actors navigating multiple systems of inclusion and exclusion. They demonstrate remarkable resilience while also facing real vulnerabilities. They contribute essential labor while experiencing social marginalization. They create innovation within constraint while also needing support and resources.

As rural communities continue to grapple with demographic change, economic transformation, and health care challenges, we need analytical tools that match the complexity of lived experience. Only by seeing immigrants in their full humanity—beyond simple legal categories—can we develop responses that serve both immigrant communities and rural America as a whole.

The post Beyond Legal Status: Rethinking Immigration and Health in Rural America appeared first on Barn Raiser.

On June 11, after decades of prohibiting farmers from repairing their own equipment, a federal court denied John Deere’s motion to throw out the Federal Trade Commission’s right-to-repair antitrust lawsuit against the company. The FTC’s lawsuit argues that Deere, the world’s largest manufacturer of agricultural machinery, violated antitrust laws by denying farmers and independent repair shops access to the diagnostic tools need to repair tractors and combines, forcing farmers to instead rely on Deere’s network of authorized dealers for needed repairs.

The FTC alleges Deere’s monopoly has led to multi-billion-dollar profits for the company while burdening farmers with extortionate repair costs—costs that farmers must bear as their livelihoods rely on the functionality of their equipment.

“If you’re harvesting 1,200 acres, you need your equipment to work on the day that it needs to be working,” says Nathan Proctor, the senior director of the Right to Repair campaign of the U.S. Public Interest Research Group (PIRG). “If you do not have working equipment in the tight window when you need it, you could lose everything—your income, your whole operation, your business.” A 2023 report published by PIRG estimated that each year farmers lose $3 billion to tractor downtime and pay $1.2 billion in excess repair costs because they need to rely on authorized dealerships for repairs.

The impact of slow repair times and equipment malfunctions is amplified given farming’s at times fast pace and the disparate geography of repair shops.

“It used to be that if you lived in a farming community, there would be a dealer within 100 miles,” says Aaron Perzanowski, a law professor at the University of Michigan whose research focuses on right to repair issues. “But because of the increasing geographic concentration of Deere dealers, there are now communities where dealers are 300-400 miles away.”

Transporting equipment for repairs is costly and time-consuming, making it all-the-more a choppy, protracted process.

Deere and other manufacturers are not just restricting access to original parts—they’re actively blocking third-party parts from being used in repairs—restricting the freedom to choose where and how farmers can repair their products, forcing them into costly manufacturer-controlled repair systems. For example, John Deere tractors can be put into “limp mode,” limiting functionality until the issue is cleared by dealer-only software, meaning farmers can’t make simple repairs without going through the manufacturer.

In January, under former chair Lina Khan, the FTC, along with the Illinois and Minnesota Attorneys General, filed a lawsuit against Deere in the last days of the Biden administration. In 2022, the Biden administration launched an investigation into Deere’s abusive practices after the National Farmers Union, Farm Action and state-level farmers unions filed a complaint with the FTC. Michigan, Wisconsin and Arizona have since joined the lawsuit.

“We applaud this court ruling, which ensures that the Federal Trade Commission can go forward with holding John Deere accountable for robbing farmers of their time and money,” says Joe Maxwell, co-founder of Farm Action, a nonpartisan agricultural watchdog organization led by farmers. “About half of America’s farmers are kept under the thumb and control of John Deere, and FTC’s action is a critical step to check that power.”

Farm Action has been a leading voice in this fight for years. In 2022, Farm Action and other advocacy groups petitioned the FTC to investigate Deere, leading to the FTC’s lawsuit.

In 2023, Trump-appointed Judge Iain D. Johnston of the U.S. District Court for the District of Northern Illinois ruled that John Deere must face similar claims from farmers who filed a class action lawsuit in 2022, which is still active despite vigorous objections from Deere (Deere & Company is headquartered in Illinois). Deere has denied nearly every allegation in the FTC’s lawsuit and moved dismiss the suit, claiming that it does not compete in the market for repair services, that the statute of limitations had run out on the states’ claims and that the states lacked standing. Deere, moreover, challenged the FTC’s constitutional authority as an independent, bipartisan board that enforces antitrust laws, arguing that restrictions on the removal of FTC commissioners illegally keeps the president from exercising oversight.

Johnston, who is also the judge in the federal lawsuit against Deere, rebutted each of Deere’s claims in his June 11 judgement denying Deere’s motion, saying that Deere failed to show how it was harmed by the FTC’s procedures for removing commissioners.

“Sequels so rarely beat their originals that even the acclaimed Steve Martin couldn’t do it on three tries,” Johnston wrote, in reference Deere’s 2023 motion to dismiss the class action lawsuit. He continued:

See Cheaper by the Dozen II, Pink Panther II, Father of the Bride II. Rebooting its earlier production, Deere sought to defy the odds. To be sure, like nearly all sequels, Deere edited the dialogue and cast some new characters, giving cameos to veteran stars like Humphrey’s Executor. But ultimately the plot felt predictable, the script derivative. Deere I received a thumbs-down and Deere II fares no better.

Deere did not respond to Barn Raiser’s request for comment.

In January 2023, a year after farmers filed their class action lawsuit, Deere released a statement claiming that it supports customers’ right to repair equipment, along with a memorandum of understanding (MOU) signed with the American Farm Bureau Federation (AFBF). The MOU stated that Deere would make its software, tools and documentation available so that farmers and independent shops would be able to make their own repairs. In exchange, the AFBF agreed not to support right to repair legislation.

While this may sound good, there is nothing binding about this statement.

“I disagree that the MOU is an effective mechanism. There’s no real enforcement of power. There are significant loopholes in the language that they signed. I also don’t think that they’re abiding by the language, and the Farm Bureau (AFBF) really doesn’t have a way to make them,” says Proctor.

The actual language used in the FTC’s lawsuit claims that Deere has a monopoly over the market. The ambiguity comes into play when it comes to how the “market” is defined—which Perzanowski says is always a contested question in monopolization cases.

“There’s some question as to whether or not the right way to define the market is looking only at restricted repair services,” says Perzanowski. “You could instead take a broader view and ask, what’s John Deere’s level of market power when it comes to repair services for their equipment in general?”

Willie Cade, board member of The Repair Association, says that the FTC’s filing importantly makes the claim that Deere’s monopolization of repair in fact affects all repairs. “It’s not a monopolization of every repair, but it affects the price of every repair, which is remarkable,” says Cade.

One significant factor is the highly computerized and technical nature of today’s tractors. According to Farm Action, a single combine nowadays can have 125 software-connected sensors, which are each connected to a controller network. Repairs can be understood in two categories: the ones that the mom-and-pop shop can still do or that you can still rely on self-repair for, and another subset that requires Deere’s own “Service ADVISOR” software, a specialized program made available only to authorized dealers that is often the only way to fully diagnose and repair Deere’s own equipment.

“Farmers have no alternatives because of the system created by Deere, which charges supracompetitive prices because of the lack of any alternatives,” wrote Johnston in his judgement. “In technologizing its equipment, Deere makes farmers reliant on Deere’s own ADVISOR software. And, in only licensing that software to its Authorized Dealers, Deere forces farmers to visit those shops instead of using closer, cheaper options.”

According to Perzanowski, the Michigan law professor, the FTC has found that nobody, apparently even John Deere, knows which parts actually require this program. “And so that makes it really hard to decide or to figure out what percentage of the overall repair market is made up of these restricted repairs,” he says. “It seems at least plausible to me that the reason John Deere can’t answer that question is precisely because they anticipated this lawsuit. It’s really helpful if you can just say, ‘We don’t know. We’ve never bothered to actually go through and make a list of these repairs.’ ”

And why might Deere’s interests seem to contradict those of the farmers who buy their equipment? Proctor at U.S. PIRG says that the demands in highly concentrated markets to increase revenue without the ability to increase sales (as these markets are limited), can lead to outcomes that violate competition laws.

Seemingly paradoxically though, a looser grip on the repair market could produce greater profits for Deere, while simultaneously creating more accessible repairs for farmers.

“Due to the lack of rights to repair their own farm equipment, farmers stand to lose $4.2 billion a year. About 20% of that is realized in higher prices for repair and services,” says Cade. “The rest is in lost yield. So imagine if farmers could get that rough number, that $3.8 billion back or even $3.7 billion back? If they could get that as profit, of course John Deere is going to do better with sales.”

There is broad bipartisan support for right to repair issues among the general public. A 2020 poll shows that 73% of Republicans, 81% of Democrats and 73% of Independents support right to repair legislation, which aims at giving individuals and independent repair shops the legal right to access service information, replacement parts and software tools to fix a broad range of equipment, from smartphones to cars to medical devices.

“The politics are very much on the margins of the whole thing,” says Proctor.

At least 40 states have introduced some form of right to repair legislation, and at least seven (California, Colorado, Connecticut, Minnesota, Maryland and New York) have passed right to repair laws.

For now, the Trump administration’s FTC appears willing to continue to pursue the lawsuit. The newly appointed FTC Commissioner Andrew Ferguson, who sat as a Republican commissioner during the Biden administration, released a dissenting opinion upon the FTC’s decision to move forward with the case. He wrote that he was dissenting on “procedural grounds,” attacking the FTC’s outgoing Democratic majority for the lawsuit’s timing—brought forth in the midst of administration changes. Yet, he acknowledged that “the right to repair one’s own equipment matters a great deal,” and wrote, “if the commission and Deere cannot reach such a settlement, then the courts will resolve the right to repair question here. Securing real relief for farmers in short order should be the commission’s focus.”

Cade at the Repair Association noted the unusual rift between pro-business factions of MAGA and conservative trade groups—two demographics that often share political interests.

“It’ll be really interesting to see in the coming time frame, if this administration is actually going to step up for farmers, or for corporations?” Cade says. “Because J.D. Vance, Josh Hawley, these guys are real anti-monopolists. And I, as a very liberal Democrat, can’t stand either of them. But as a right to repair advocate, both of them are on my side.”

For Cade, a lifelong advocate for farmers and repair rights, this presents an opportunity. He is enthusiastic about the prospect of these more homogenized political factions to splinter off into more nuanced interest groups as this issue evolves. There is already clearly a major disconnect between the national leadership and trade members.

“There are two basic trade organizations that are in on this [lawsuit],” said Cade. “One is the American Farm Bureau Federation, and they signed an MOU with John Deere. They’re always saying, ‘Don’t pick on our manufacturers,’ ‘We love our manufacturers’ … But I went down to the AFBF conference, and every person that I talked to except two people who were on staff were like, ‘Oh, yeah. This is a really important issue for us.’ ”

According to Perzanowski, this case will at best require a couple of years before it gets to the first round of appeals.

In the meantime, right to repair advocates will continue to make noise. Whether policymakers and courts side with them—or with corporate giants like Deere—we’ll have to wait and see.

The post Right to Repair Gains Traction as John Deere Faces Trial appeared first on Barn Raiser.

Powering Rural Futures: Clean energy is creating new jobs in rural America, generating opportunities for people who install solar panels, build wind turbines, weatherize homes, and more. This five-part series from the Rural News Network explores how industry, state governments, and education systems are training…