Larry Lafferty, Chase Brackley and David Winchell unload a truck last month at the Nelsonville Food Cupboard in the rural community of Nelsonville, Ohio. (Andrew Spear for The Washington Post)
By Jennifer Rubin
Opinion writer

President Trump has relied upon rural Americans for votes and ongoing political support to an extent unprecedented in modern America. He has bonded with them over their shared resentment of urban elites, styled himself as a defender of their faith (apparently Christmas was not celebrated openly before his presidency) and promised to redo trade deals to make them prosperous.

To this day, he visits red America to soak up the applause and to boost candidates. In turn, rural America has voted for him and his Senate allies (most recently in Indiana, North Dakota and Missouri).

So what has Trump done for (or to) rural America? His health-care bill, thwarted in the Senate, would have hiked costs in rural America. His tariff war is now wreaking havoc in the agricultural heartland. Robert Leonard wrote in July in the New York Times, "The cost of being shut out of overseas markets for soybeans, beef, pork, chicken and more will be in the billions. Once those markets are gone, they will be difficult to recover. Commodity prices continue to drop, and good weather suggests an excellent crop is in the making, which will drive prices further down."

To soften the blow from tariffs, Trump gave them what amounts to $12 billion in welfare — which has been slow in coming. ("A $12 billion bailout program Mr. Trump created to 'make it up' to farmers has done little to cushion the blow," reports the New York Times, "with red tape and long waiting periods resulting in few payouts so far. According to the Department of Agriculture, just $838 million has been paid out to farmers since the first $6 billion pot of money was made available in September.")

In addition, ideologically driven budget cuts hit rural areas more acutely. Bloomberg reports:

Federal money rescued rural America after the Great Depression of the 1930s, as the government poured resources into job-creating investments. Today, Washington's main presence in places like Clay County is the U.S. Department of Agriculture. It helps with everything from building houses to providing medical services. Clay County got a $50,000 grant this year for an ambulance, an urgent need in a region blighted by opioid addiction.

The agency also helped bring wireless Internet to remote areas. That creates opportunities for people to "make good wages from their home,'' said Anne Hazlett, the USDA's assistant to the secretary for rural development.

But the Trump administration plans to cut USDA funding by 16 percent in fiscal 2019, and revamp the food stamps it distributes.

Residents call that sort of cut "catastrophic."

To be frank, rural America is dying. A new report from the Centers for Disease Control and Prevention finds, "In 1999, the age-adjusted suicide rate for the most rural (noncore) counties (13.1 per 100,000) was 1.4 times the rate for the most urban (large central metro) counties (9.6). This difference increased in 2017, with the suicide rate for the most rural counties (20.0 per 100,000) increasing to 1.8 times the rate for the most urban counties (11.1)."

This is not to say the rural/urban divide started with Trump. Since 2000, rural counties have lost population and become older and whiter in comparison with the rest of the country. Moreover, Pew Research this year released findings showing that "three-in-ten rural counties (31%) have concentrated poverty, compared with 19% of cities and 15% of suburbs. … Rural counties also trail other types of communities, especially urban counties, on key measures of employment of prime-age workers — those 25 to 54 years old. For example, 71% of rural residents of prime working age are employed, compared with 77% in both urban and suburban counties."

The Post reported in 2017:

The Institute for Health Metrics and Evaluation researchers looked at death certificates from 1980 through 2014. Among the places with sharply increased life expectancy and lower deaths over that period are the District of Columbia and Loudoun County, Va. — where life expectancy is up 12.8 and 12.4 percent, respectively. Fairfax County has the lowest all-cause death rate in the metropolitan Washington region, significantly lower than the national average.

Of the 10 counties where life expectancy has dropped the most since 1980, eight are in Kentucky. The other two are in Oklahoma and Alabama. The report includes an interactive map of death rates county by county (and sometimes by city, when a city is not part of a county). The areas with the worst mortality metrics include central Appalachia, the Mississippi Delta and areas in the Dakotas with large Native American populations.

Nevertheless, the urban/rural divide is getting worse, not better, under Trump. Moreover, as someone who owes his presidency to rural Americans and has promised them the moon and the stars, the results are paltry at best. In place of concrete policies that help these areas, he offers them anger, resentment and scapegoats (e.g. illegal immigrants).

Democrats have an opening here to do what Republicans will not — recognize that Trump's brew of supply-side economics and protectionism is awful for rural Americans, who need open markets, regional development, rural broadband and affordable health care. (We've already seen in places such as Kansas that Republican state tax cuts brought economic ruin, a teachers' revolt — and a new Democratic governor.) Democrats might consider appealing to the men and women Trump forgot.