As the midterm elections draw closer, a growing wave of frustration over the escalating cost of living is sweeping through rural American communities. According to a new comprehensive survey conducted by KFF and the Associated Press, these compounding economic pressures appear to be dampening voter enthusiasm among a demographic that has historically served as a bedrock of support for President Trump and the Republican Party.
The nationwide poll, which captures the views and lived experiences of more than 2,000 registered rural voters, shines a spotlight on an electorate facing severe economic stress. While rural communities have long leaned reliably conservative, the day-to-day realities of inflation, surging household expenses, and escalating health care costs are introducing new political dynamics. The survey project combines rigorous polling analysis from KFF—an independent source for health policy research, polling, and journalism that frequently partners with media organizations—with in-depth reporting from journalists at the Associated Press and KFF Health News. This joint investigative effort aims to unpack how economic anxiety at the kitchen table translates into political sentiment in the voting booth.
The survey explores a wide array of factors shaping the rural outlook, extending beyond broad economic metrics to examine specific challenges facing these communities. Researchers probed voters’ perspectives on local job opportunities, community safety, trust in political leadership regarding key economic and health care matters, and persistent health care access barriers. Among the most pressing concerns highlighted by respondents are structural deficiencies within their local health care ecosystems, including severe shortages of medical providers and local hospitals that leave many residents traveling long distances for essential care.
This project forms a cornerstone of KFF’s "Health in the Midterms" series, a dedicated collection of policy research, public opinion polling, and specialized news reporting designed to track how health care issues intersect with the electoral landscape. As campaigns enter their critical phases, the findings underscore how kitchen-table economics—particularly the rising burden of medical and daily living expenses—can influence voter motivation and reshape political loyalties in unexpected ways.
Methodology and Background
Designed and analyzed by public opinion researchers at KFF and the Associated Press, the survey was fielded from August 12 through August 24, 2026. Data was collected both online and via telephone using a nationally representative sample of 2,241 U.S. adults who are registered to vote and reside in designated rural areas across the country.
To ensure accuracy and inclusivity, the survey was administered in both English and Spanish. For the full sample of rural voters, the margin of sampling error is plus or minus three percentage points, though researchers note that the margin of error may be higher for specific subgroups depending on sample sizes.
Both KFF and the Associated Press bring extensive institutional histories to the partnership. KFF operates as a nonpartisan source of information for policymakers, the media, the health policy community, and the general public, producing independent health policy research, polling, and journalism through outlets like KFF Health News. Meanwhile, the Associated Press, founded in 1846, is an independent global news organization dedicated to factual reporting. Serving as a trusted source of fast, accurate, and unbiased news across multiple formats, AP journalism reaches more than half the world’s population every single day, providing the essential infrastructure and services vital to the modern news ecosystem.
Additional stories drawing deeper insights from the poll findings and individual rural voters’ perspectives are scheduled to be published in the coming weeks as the midterm elections approach.
