Journal of Advances in Food Science & Technology

Agrochemical use across North American farming landscapes has grown substantially over recent decades, raising difficult questions about who bears the resulting health risks and whether those risks are equitably distributed. This article presents a critical narrative review of the spatial epidemiology of agrochemical exposure in North American farming communities, drawing on peer-reviewed literature published between 1 January 2000 and 28 February 2026. The review integrates evidence from GIS-based exposure assessment, prospective cohort studies, and case-control analyses conducted across the United States and Canada. A consistent theme runs through this literature: racial and ethnic minorities, migrant farmworkers, women of reproductive age, and children in periagricultural communities are exposed to synthetic agrochemicals—including organophosphates, glyphosate, and related herbicide formulations—at rates that substantially exceed those of the general population. These exposures have been associated with a range of serious health outcomes, including non-Hodgkin lymphoma, leukaemia, neurological disease, neurodevelopmental deficits in children, reproductive and endocrine disruption, and respiratory impairment. Spatial analytic methods—disease mapping, cluster detection, and kernel density estimation—have helped to identify which communities are most at risk and why, yet exposure misclassification and methodological heterogeneity continue to limit the field's inferential reach. The review concludes that a more equitable regulatory approach to agrochemical risk must begin with better surveillance, disaggregated biomonitoring data, and explicit attention to who carries the greatest burden.