Rural areas have been shedding jobs and population for decades, but the problems are growing worse. Farm consolidation has reduced the number of agricultural jobs, while thousands of factories in rural areas have closed due to automation and overseas competition. Although some rural communities are doing well, hundreds have high levels of poverty and unemployment. Because of the poor economic prospects, rural counties typically lose up to a third of their high school classes within two years of graduation as young adults flee to metropolitan areas where jobs are more plentiful. Those left behind tend to be older, and many have severe health problems. Addiction and suicide are on the rise, and life expectancy is dropping. During the presidential campaign, Donald Trump pledged to bring manufacturing and mining jobs back to such areas, which voted overwhelmingly for him. But some observers warn that his policies on immigration, trade and health care, as well as his proposed budget cuts, could hurt rural America.