Growing up gifted and working-class in the foothills of the Ozarks, Monica and Darci became fast friends. Bonding over a shared love of learning, they vowed to escape their broken town. In the end, Monica left Clinton for university and fulfilled her dreams. Darci, along with many in their circle of friends, did not. Years later, working as a journalist covering poverty, Monica discovers what she already intuitively knew about the women in Arkansas. Their life expectancy had steeply declined -- the sharpest such fall in a century. As she returns to Clinton to report the story, she reconnects with Darci, and finds that her once talented and ambitious best friend is now a statistic: a single mother of two, addicted to meth, jobless and nearly homeless. Deeply aware that Darci's fate could have been hers, she retraces the moments in each of their lives that led such similar women toward such different destinies.