North Dakota's Rural Counties See Highest Cancer Death Rates

Stacker analysis finds rural agricultural counties have the state's top cancer mortality figures.

Published on Feb. 16, 2026

Got story updates? Submit your updates here. ›

A new report from Stacker has identified the 10 North Dakota counties with the highest cancer death rates, with all of the top counties being rural, agricultural areas. The data, compiled from the National Institutes of Health, shows cancer mortality rates ranging from 156.2 deaths per 100,000 in McHenry County to 220.0 deaths per 100,000 in Rolette County between 2019-2023. Experts cite factors like exposure to cancer-causing chemicals, barriers to early screening, and socioeconomic disadvantages as contributors to the elevated cancer rates in these rural regions.

Why it matters

This data highlights significant health disparities between North Dakota's urban and rural populations, with the state's agricultural heartland experiencing disproportionately high cancer mortality. Understanding the underlying causes, which likely include environmental, economic, and access to care factors, is crucial for developing targeted interventions to support these communities and reduce preventable cancer deaths.

The details

The Stacker analysis examined cancer death rates across all 53 North Dakota counties, with the top 10 being predominantly rural areas reliant on agriculture. Factors like exposure to pesticides and other chemicals, barriers to preventative screenings, and socioeconomic disadvantages in these communities are believed to contribute to the elevated cancer mortality. For example, Rolette County, which had the highest rate at 220.0 deaths per 100,000, is home to the Turtle Mountain Indian Reservation and has high poverty levels. Similarly, Burke County in the northwest part of the state had the second-highest rate at 191.1 deaths per 100,000.

  • The data covers cancer deaths in North Dakota from 2019 to 2023.
  • The Stacker report was published on February 16, 2026.

The players

National Institutes of Health (NIH)

The NIH is the primary agency of the United States government responsible for biomedical and public health research.

Stacker

Stacker is a data-driven media company that publishes news and analysis on a variety of topics.

Got photos? Submit your photos here. ›

What they’re saying

“The 'C' word. I hate to even say it, let alone type it.”

— Rockin' Rick, Author (supertalk1270.com)

What’s next

Researchers and public health officials in North Dakota will likely examine this data further to identify the root causes of the elevated cancer rates in rural counties and develop targeted interventions to address the issue.

The takeaway

This report underscores the significant health disparities between North Dakota's urban and rural populations, with the state's agricultural heartland experiencing disproportionately high cancer mortality rates. Addressing the complex factors contributing to these elevated cancer deaths, including environmental exposures, economic disadvantages, and barriers to preventative care, will be crucial for supporting the health of these communities.