More than a rural revolt: Landscapes of despair and the 2016 Presidential election

• Trump's rural advantage contributed to his Presidential election victory, but it was not sufficient to swing the election. • Trump's average over-performance was higher in more economically-, socially-, and health-distressed counties. • Trump performed better in counties with economic distress, poor health, low educational attainment, and high divorce rates. • Localized economic, social, and health distress were salient contributors to the 2016 Presidential election outcome.