This spring, Democrats desperate for signs of a possible political comeback took heart when a young political novice, Jon Ossoff, came within two points of winning a special election in Georgia’s Sixth Congressional District. Ossoff raised a record-breaking $8.3 million in three months and will face Republican Karen Handel in a runoff election on June 20. The seat, once famously occupied by Newt Gingrich, had recently been vacated by Tom Price, Donald Trump’s new secretary of health and human services. Though Price won reelection easily last fall, with 62 percent of the vote, Hillary Clinton ran surprisingly strongly, losing to Trump by only 1.5 percentage points—a vastly better showing than Barack Obama, who in 2012 was trounced by twenty-three points.

In the Washington Post, Paul Kane explained that the Democratic Party was targeting the seat as part of an “emerging strategy of focusing on dozens of GOP seats in diverse, well-educated suburbs across the country in advance of next year’s elections.” The race for Price’s old seat, added the Post’s Greg Sargent, “is being widely examined as a bellwether for 2018, because it’s a lot like many other GOP-held districts that Democrats will target—ones in which Trump won by a very slim margin or lost, and ones that are heavily populated with college-educated white and suburban voters.” NBC News reported that Georgia’s Sixth was one of ninety-seven districts the Democrats had identified in which Trump prevailed with 55 percent or less of the vote.

This strategy is rational if your primary focus is to pick up seats in the House of Representatives in 2018. Districts where Trump did the worst are the obvious low-hanging fruit. Those tend to be places like Georgia’s Sixth: metro areas with growing numbers of the “rising electorate” of college-educated professionals, single women, Millennials, immigrants, and other minorities who formed the core of the Obama coalition.

The strategy is highly questionable, however, if the goal is to win more broadly—say, the presidency in 2020. After all, the Democrats approached the disastrous 2016 election precisely on the theory that presidential contests are less about persuasion than about turning out your base, and that the most efficient way to turn out your base is to focus on where most of your supporters live. By crafting messages targeted to suburban professionals (and with a heavy assist from Donald Trump’s alienating campaign), the strategy worked well—in those areas. But the overall result was catastrophic. Trump won by much higher percentages than previous GOP presidential candidates in exurban and rural districts—enough (with a little help from the Russians and James Comey) to put him in the White House.

The debate within the Democratic Party about how best to win back power—reach out to rural white working-class voters, or work harder on appealing to educated professionals and other members of the rising electorate—does not align with the perceived divide between the Clinton and Bernie Sanders wings. True, Sanders’s candidacy was partly based on the premise that a populist economic message could sell well in the Rust Belt industrial towns and declining rural areas that have been gravitating to the right. But even within Clinton’s camp, many people—most notably her own husband—thought her campaign was making a terrible mistake by not fighting for those voters.

People in rural and small-town America know the dangers of industry consolidation better than anyone, having seen it strip away the livelihoods of independent farmers and local banks and merchants long before most city slickers even realized that corporate concentration was an issue.

Since November, the confusion has only deepened. On the one hand, Democrats know that they are getting killed in the hinterlands and the heartland, and that this spells trouble not just at the national level but in the states as well. On the other hand, they are appalled by voters who supported Trump in spite of—or was it because of?—his evident racism, misogyny, personal corruption, and general contempt for accepted facts. And they worry that trying to win these folks over is more than just doomed; it could alienate the Democratic base by diluting key values that define modern progressivism: racial equality, women’s rights, gay rights, and commitment to addressing climate change.

Democrats are increasingly realizing that to resolve this paradox they need what Senate Minority Leader Chuck Schumer calls “a strong, bold economic message,” one that strikes a chord with rural white voters without alienating the base. Several Democrats seen as future leaders of the party, such as Ohio Senator Sherrod Brown and Ohio Representative Tim Ryan, have even floated specific policy plans they think would do the trick. Unfortunately, their ideas—a higher minimum wage, paid family leave, an expanded Earned Income Tax Credit, universal high-speed broadband—are pretty much the same ones Hillary Clinton ran on without success.

There is a much more powerful economic agenda hiding in plain sight. Americans from all walks of life are beginning to wake up to the way our economy, and indeed our way of life, has come under the control of an ever-smaller handful of ever-larger business monopolies. The bloody face of David Dao getting dragged off a United Airlines flight made many Americans question why, for instance, we let the airline market get cornered by four companies that can abuse us with impunity.

People in rural and small-town America know the dangers of industry consolidation better than anyone, having seen it strip away the livelihoods of independent farmers and local banks and merchants long before most city slickers even realized that corporate concentration was an issue.

All this points to a simple conclusion: Democrats should make fighting monopolies the central organizing principle of their economic agenda. This approach holds the promise of bringing together groups that seem inherently at odds: nativists and cosmopolitans, fundamentalists and secularists, urbanites and rural dwellers.

The strongest reason to think this could work is, quite simply, that it has worked before. A century ago, agrarian populists and big-city progressives united around a common opposition to monopoly, forming a movement that dominated American politics for decades and helped deliver a broadly shared prosperity. Because the economic landscape today is strikingly similar to what it was a hundred years ago, there’s every reason to believe that the conditions are right for a similar alliance to arise again.

Thanks to the design of the Electoral College and the Senate, political power in America has always been influenced almost as much by the geographical reach of the political parties as by their ability to attract the most raw votes. And over the past two decades, the left has suffered a very unfavorable geographic realignment.

One good way to see this is to look at the changes in county-level voting behavior in presidential elections. It wasn’t so long ago that a roughly equal number of counties supported the two main presidential contenders. In 1992, Democrat Bill Clinton nearly matched the performance of Republican George H. W. Bush, winning 1,519 counties to Bush’s 1,582. (Even then, the Republicans held an advantage; Bush won his counties with only 37 percent of the national popular vote.) The county totals were almost identical when Clinton defeated Bob Dole four years later.

That would turn out to be a high-water mark for the Democrats. Even while narrowly winning the popular vote in 2000, Al Gore carried only 659 counties to George W. Bush’s 2,397. John Kerry did even worse in the close 2004 election. But the worst performance since Walter Mondale’s 1984 shellacking came in 2016, when Hillary Clinton topped Donald Trump in only 489 of America’s 3,141 counties.

Overall, Donald Trump carried 220 counties that had voted for Obama in 2012, while Hillary took only seventeen that had gone for Mitt Romney. Even more significantly, Trump got a larger share of the vote than Romney in 2,728 counties. Clinton outperformed Obama in only 383.

Of course, you can’t gauge the health of a political party purely by counting the number of counties won. As Fordham University political scientist Costas Panagopoulos pointed out to Politifact in December, “Loving County, Texas, has a population of 82, while California’s Los Angeles County has over 9.8 million.” But by other indicators, the left’s growing geographic isolation has had dreadful electoral consequences, of which Donald Trump is only the most visible example. For instance, at the beginning of 1998, Republicans controlled both chambers in seventeen state legislatures and the Democrats controlled both in twenty; twelve were split. (Nebraska has an officially nonpartisan unicameral legislature.) Today, Republicans control thirty-two legislatures, Democrats control fourteen, and only three are split. In American politics, geography matters, and Democrats are close to falling off the map.

Part of the problem is that, as Democratic voters sort themselves more and more into dense urban and suburban districts, they become sitting ducks for Republican gerrymanders that dilute their ability to elect representatives to state legislatures. And it’s a problem that compounds on itself. State legislatures have the biggest role in drawing federal congressional districts; lower-level politicians form the farm team for candidates for higher state and federal offices; and the federal government is getting increasingly into the habit of off-sourcing policymaking decisions to state governments, as with the Affordable Care Act’s Medicaid expansion. It’s hard to exaggerate how devastating it is for the left to be shut out of power on the state level.

Based on the polling data, Hillary Clinton had a seemingly comfortable lead in Pennsylvania heading into election night. As the results began to come in, she appeared to be meeting her targets. While her margin of victory in Philadelphia was 17,062 votes smaller than Obama’s four years earlier, she more than made up for it by netting 17,489 more votes in Pittsburgh’s Allegheny County. In the all-important Philly suburbs, Clinton improved on Obama’s 2012 margin by around 65,000 more votes. With those results from Democratic strongholds, Clinton seemed well on her way to an easy victory.

At Clinton headquarters, the first sign that something was amiss came shortly before the polls closed in Pennsylvania. At around 7:45 p.m., Steve Schale, a Clinton operative from Florida, called with the news that Trump was going to win that state. Clinton was doing well and hitting targets in blue areas, but Trump’s margins in Republican areas were astronomical. “You’re going to come up short,” Schale told them. Losing Florida was disappointing, but not catastrophic. The same couldn’t be said for Pennsylvania.

In Pennsylvania, Hillary Clinton won the big counties, but she lost the small counties so badly it didn’t matter. The state, along with the country, had realigned, but the realignment wasn’t an even trade.

Observers had noted that Trump appeared to be running stronger than Romney had in rural and exurban parts of the state, but almost no one (and certainly not the pollsters) realized by how much. Clinton would underperform Obama by at least ten points in twenty-three of Pennsylvania’s sixty-eight counties. (For the purposes of this article, I’m discussing vote percentages in terms of the total two-party vote—the number of votes for either the Democratic or Republican candidate—to avoid getting the distorting effects of third parties.) When all the votes were counted (and recounted), she would lose the state by a razor-thin 44,292 votes.

One way to illustrate what happened is to look at two adjacent southwestern counties that border West Virginia.

In 2008, Obama essentially tied John McCain in Greene County, losing by just sixty votes. In 2012, Obama lost to Romney by 2,576 votes. But 2016 was a disaster: Clinton won a mere 29 percent of the Greene County vote, costing her 6,367 net votes. Trump picked up 14 percent of his statewide margin from a county that produced fewer than 16,000 total two-party presidential votes.

Just to the north, in more populous Washington County, the erosion was both less extreme and more consequential. Obama lost Washington County by 4,571 votes in 2008 and by 12,885 in 2012. In 2016, Clinton lost by 25,064, which was more than half of the statewide margin. These two lightly populated and heavily white working-class counties alone accounted for 71 percent of Trump’s margin of victory.

In the late 1970s, one-fifth of the country’s new businesses were launched outside of metro areas. Today, only 12 percent are. It’s probably no coincidence that the changing political allegiance of Greene County, Pennsylvania, has come at a time when fully 53 percent of its adult population is not working.

The rural tidal wave more than wiped out Clinton’s advantage in places like Chester County, in the Philly suburbs. Mitt Romney had carried the affluent and traditionally Republican county by 539 votes. Trump’s style, policies, and record of sexual assault weren’t expected to play with Romney Republicans, and they didn’t: Clinton won Chester by 25,568 votes. But that was essentially single-handedly neutralized by Washington County, which has a population less than half the size of Chester’s. Clinton won the big counties, but she lost the small counties so badly it didn’t matter. The state, along with the country, had realigned, but the realignment wasn’t an even trade.

Initially, there was a lot of confusion about what had happened. It was anticipated that black turnout might not match recent levels, and that proved to be true. Another theory was that Trump’s huge numbers in red counties were driven by new voters stirred out of complacency by the novelty and celebrity of his campaign. But, as more data emerged, it became clear that the crucial factor was Obama voters who defected to Trump or to a third party.

The Democratic political firm Global Strategy Group found that 70 percent of the Democrats’ drop-off from their 2012 presidential vote could be attributed to Obama voters switching sides. In a joint study, GSG and Catalist found that, contrary to expectations, Clinton did better than Trump among new voters in Ohio. New York Times political analyst Nate Cohn similarly concluded that weak turnout among black voters had been exaggerated and noted that “almost one in four of President Obama’s 2012 white working-class supporters defected from the Democrats in 2016, either supporting Mr. Trump or voting for a third-party candidate.”

That evidence finally puts to rest the arguments that Clinton’s loss is explained by a failure to turn out her base or by an army of previously apathetic voters coming out of the woodwork for Trump. Democratic strategists are therefore coming around to the idea that they can’t kiss off the white working-class part of their traditional New Deal coalition. To climb out of the hole they’re in, candidates will have to engage with small-town and rural constituents where they are.

Here’s what they’ll find when they get there. To begin with, a mass die-off. Since it began nearly two decades ago, an epidemic has spread across most of the American landmass that has caused more premature deaths than AIDS. Yet it wasn’t until 2015 that the New York Times took note of it.

The geography of the epidemic is telling. The states most affected—Alabama, Kentucky, Tennessee, and Mississippi—are in deep red zones. There are now counties in Appalachia where life expectancy is shorter than in Bangladesh. Also hard hit, however, are the rural counties and small towns and cities throughout “flyover” America. With few exceptions, the only territories that have been largely unaffected are the deep blue zones of deep blue states: coastal California, downstate New York, the I-95 corridor along the mid-Atlantic coastline.

Just as the epidemic has a particular geography, it also affects a particular demographic group. As two Princeton University professors, the husband-and-wife team of Angus Deaton and Anne Case, recently confirmed in a new paper, it’s overwhelmingly concentrated among working-class whites, who have experienced increasing mortality rates every year since 1999 even as life expectancy has improved for every other demographic group. In 1999, the mortality rate for non-Hispanic white people aged fifty to fifty-four with only a high school degree was 30 percent lower than the mortality rate of black people as a whole in the same age group; by 2015, it was 30 percent higher. The proximate cause of this die-off is “deaths of despair” brought on by record levels of alcoholism, drug overdoses, and suicide.

If you look at a map of where these deaths of despair are concentrated, you’ll see that it tracks closely with another map, developed by the Economic Innovation Group, that color-codes counties according to their levels of economic distress. These maps show regional inequality growing as more and more of the country’s wealth and economic growth becomes concentrated in a few elite urban, coastal areas. Meanwhile, rural America contracts and depopulates, and once-thriving heartland cities and metro areas fall further and further behind.

One telling statistic captures the decline of rural America. In the late 1970s, one-fifth of the country’s new businesses were launched outside of metro areas. Today, only 12 percent are. That is not enough to replace those that go out of business, so the number of rural businesses continues to shrink, along with opportunities for rural Americans to make a living. It’s probably no coincidence that the changing political allegiance of Greene County, Pennsylvania, has come at a time when fully 53 percent of its adult population is not working.

It’s not just in rural areas where business dynamism is pretty much played out. Nearly two-thirds of U.S. metro areas saw more businesses close than open in 2014. With the exception of a few elite cities, most of America is, in a very real sense, going out of business. And the businesses that remain are more and more likely to be owned by corporations headquartered somewhere else, leading to the effective colonization of local economies. (See Brian S. Feldman, “The Real Reason Middle America Should be Angry,” Washington Monthly, March/April/May 2016.)

If you live in a place where the steel mills and the downtown stores closed twenty years ago, and the malls and the local hospital are closing today, it has been a long time since any national politician besides Trump seemed aware you existed. Indeed, if anyone in blue zone America noticed, whether on the left or the right, they were likely to conclude that it’s your own fault for being a racist or a slob or both.

Here is Kevin Williamson’s take in the March 28, 2016, issue of the National Review:

The truth about these dysfunctional, downscale communities is that they deserve to die. Economically, they are negative assets. Morally, they are indefensible. . . . The white American under-class is in thrall to a vicious, selfish culture whose main products are misery and used heroin needles. Donald Trump’s speeches make them feel good. So does OxyContin. What they need isn’t analgesics, literal or political. They need real opportunity, which means that they need real change, which means that they need U-Haul.

As hard-sounding and uncharitable as that advice sounds, Williamson is only saying explicitly what many distraught Democrats are feeling. If Trump’s racism was a plus and his sexual assaults weren’t a deal breaker and his attack on Muslims seemed about right, then maybe these people really do belong in a basket of deplorables. Maybe they are best considered implacable political foes who can’t be reasoned with and should be left to their miserable fates.

Yet how is that different from scapegoating “inner city” residents of America’s “ghettos” as an “underclass” beset by “pathologies,” as liberals rightly castigate conservatives for doing? Telling the white working class that they should just move to San Francisco is like telling poor urban black people that they should stop complaining and relocate to Chappaqua. Even if many white Trump voters were motivated by racism, the fact remains that a substantial number of them voted for a black guy in 2008 and 2012. Writing them off as irredeemable is both politically and morally wrong.

Conservative columnist George Will recently noted that “[t]he 1930s confounded the European left because capitalism’s crisis benefited the rancid right, which by melding economic and cultural anxieties produced aspirations from the base metal of resentments.” It’s hard not to see the parallels to the election of Donald Trump. When poor and working-class people in the city feel abandoned or unrepresented by the Democrats, they take to the streets in protest; whites in the country turn to right-wing populism or fascism. The left may think it can leave rural and working-class whites behind, but this will come with a price tag they don’t want to pay.

Telling the white working class that they should just move to San Francisco is like telling poor urban black people that they should stop complaining and relocate to Chappaqua.

Democrats may also be tempted to think that they can focus on the educated, suburban places where Clinton outperformed Obama as they plan to take back the House in 2018, then simply switch to an appeal to rural voters for the 2020 presidential election. But that approach is risky. Building a new political movement around a new economic agenda takes time. If the Democrats spend the next year and a half trying to get the most out of the areas where Clinton did well, that’s time not invested in repairing the damage to their brand in the 220 counties that flipped from Obama to Trump. It’s another year and a half for rural voters to feel ignored, adding to their sense of grievance. Losing Pennsylvania and Michigan and Wisconsin was almost unthinkable during the 2016 campaign, but the surest way to lose those states again in 2020 is to fail to address, or even to exacerbate, the problems that led to defeat.

In many ways, we’ve been here before. At the turn of the last century, heartland America was deeply troubled and full of grievances against elites. Millions of American farmers saw their way of life threatened by falling commodity prices, predatory lenders, and monopolistic railroads and grain dealers. Small-town merchants faced extinction at the hands of giant chain stores and mail order catalogs. Christian fundamentalism would for the first time become a powerful self-conscious force in American society, along with a revitalized Ku Klux Klan expanding out of the South to places like Indiana and the industrial Midwest.

Building a new political movement around a new economic agenda takes time. If the Democrats spend the next year and a half trying to get the most out of the areas where Clinton did well, that’s time not invested in repairing the damage to their brand in the 220 counties that flipped from Obama to Trump.

Yet from this volatile mix came not a fascist takeover, but a fusion of populism and progressivism that for all its tensions became a supermajority movement, drawing support from all over the country and nearly all walks of life. The greatest concentration of support for progressive legislation in Congress in U.S. history would come from southern and midwestern states that, after 1968, would vote consistently for conservative Republicans.

The common cause that drew this coalition together was opposition to monopoly. Then as now, the effects of increasing corporate concentration were felt first and hardest in rural America. Railroads held prairie farmers captive with monopolistic freight tariffs. Ranchers were at the mercy of the “Big Five” meat packers, who offered them “take it or leave it” prices. Monopolistic eastern bankers peddled predatory loans to homesteaders, even bundling them up into what we today call derivatives and reselling them to unsuspecting European investors.

The result was populist prairie fire. An agrarian “Granger” movement pushed state governments to regulate private services like railroads and grain storage facilities. In 1887, Congress created the first federal regulatory agency, the Interstate Commerce Commission. By 1890, discontent among farmers and small-scale producers of all kinds would lead to passage of the Sherman Antitrust Act, which its namesake sponsor said was necessary to protect the “right of every man to work, labor, and produce in any lawful vocation and to transport his production on equal terms and conditions and under like circumstances.” By 1896, populism would capture the Democratic Party and make William Jennings Bryan its standard-bearer.

Bryan, of course, never made it to the presidency, but as the forces of monopoly continued to advance, urban professionals began to feel threatened as well. The result was a fusion of populism and progressivism that took over the full spectrum of American politics. By the election of 1912, four candidates—incumbent Republican William Taft, Democrat Woodrow Wilson, Teddy Roosevelt, running on the Progressive Party ticket, and Eugene Debs, running as a Socialist—all competed over who had the best ideas for containing monopolies. Wilson carried the day, and went on to attack monopolies through the creation of institutions that vastly expanded the government’s ability to prevent mergers and protect independent producers.

A generation later, southern, white populists and northern, urban progressives came together again to form the New Deal coalition, united in common opposition to Wall Street financiers and the other “economic royalists.” Though it is not well remembered today, much of the New Deal, particularly after FDR’s first term, focused on busting monopolies and passing fair trade laws to protect small-scale producers of all kinds, from farmers and small-town merchants to independent businesses in urban America. This program was so successful, both politically and economically, that Republicans generally embraced it as well and monopoly faded as an issue in American politics for decades. (See Phillip Longman, “How to Make Conservatism Great Again,” Washington Monthly, November/December 2016.)

Today, however, monopoly is once again a problem. And, as in the past, heartland Americans have been among the first to feel its effects. At the Brookings Institution, scholars have only recently figured out that increasing corporate concentration has stifled entrepreneurialism, but ranchers and farmers have known all about that for years. Some 84 percent of the meat-packing industry is controlled by just four companies. In most of the country, just one or two (colluding) milk processors dictate the prices they pay to dairy farmers. Monsanto long ago achieved overwhelming control over seed production. Just four railroads control 86 percent of the grain and oilseed traffic in the United States, and in most of rural America, a single corporation monopolizes all rail traffic in all directions, charging the absolute most that the market will bear.

Again, as in days of old, the effects of concentration are now spreading so that they threaten metropolitan America as well. Too-big-to-fail banks helped cause the Great Recession. An airline industry in which just four companies now control 85 percent of the market increasingly gets away with overcharging and mistreating fliers, including forcibly removing paying customers thanks to an overbooking system that jacks up corporate profits.

At the same time, platform monopolies like Amazon and Facebook are stripping away the ability of musicians, authors, and journalists to make a living. Consolidation in health care means fewer and fewer hospitals competing to hire nurses, while independent doctors are forced to sell their practices to corporate masters. Academic scientists find that they must increasingly raise their own salaries from plutocratic donors, who also increasingly control the rest of America’s nonprofit sector and civil society as well. Monopoly has become such a problem in America that even the Economist has begun encouraging the U.S. government to rediscover its antitrust powers.

What distinguishes anti-monopoly enforcement—using the federal government’s power to regulate monopoly industries, break them up, or prevent them from forming—as a political issue is its potential to be a unifying force and coalition builder. It promises not only to restore entrepreneurship and economic vitality to small-town America, but also to help Pakistani business owners in Brooklyn and Silicon Valley inventors stifled by colluding tech behemoths.

It could unite populists and progressives in a way reminiscent of the uneasy alliance they formed to bring us the Progressive Era and the New Deal. It would give Democratic politicians in rural counties a set of policy proposals and messages that actually address the problems facing their communities, something the Republicans’ culture wars and pro-monopoly, limited-government ideology have utterly failed to do. Some pioneering Democrats, including Senator Elizabeth Warren, have already embraced anti-monopoly as a theme, and others, notably former Representative Tom Perriello, running for governor of Virginia, have explicitly seized on it as a strategy for building an alliance of rural populists and urban progressives. (See “The Monthly Interview: Tom Perriello.”)

At the turn of the last century, heartland America was deeply troubled and full of grievances against elites. Yet from this volatile mix came not a fascist takeover, but a fusion of populism and progressivism that for all its tensions became a supermajority movement.

Anti-monopoly politics won’t magically erase the country’s cultural divide. Reproductive rights, gun control, police brutality, and energy policy will remain fierce points of contention. What anti-monopoly politics can do is give Democrats a message that has urgent relevance to rural and small-town America and is much more likely to improve their economic conditions than border walls and trade wars. It could even help the party preserve unity on cultural issues. It is often assumed that the best way for Democrats to compete in these areas is to eliminate the distinctions on abortion or gay rights or guns and try to craft a more appealing platform on what remains. That was essentially the Blue Dog model—until the Blue Dog Caucus all but went extinct after the 2010 and 2014 midterms.

With that strategy dead, and distasteful in the first place, Democrats in red areas should welcome a new plan that allows them to speak directly to the needs of the people they want to represent. Throwing out the defensive playbook for an offensive one offers the opportunity to cast aside stale assumptions on what positions a candidate has to adopt in order to be competitive.

Donald Trump taught us that. He could buck Republican ideology on trade and entitlements. He could win over evangelicals despite his notorious sexual behavior. He could even flip-flop on core issues like abortion and nationalized health care without it making a damn bit of difference. The lesson for Democrats may be that they can get away with being pro-choice in an anti-choice district, and pro-climate in a coal-extraction economy, but only if their economic message kicks the shit out of the message coming from the other side.

The progressive left should hope this theory is correct, because the alternative is to abandon these districts to right-wing extremists and continue getting steamrolled in elections from the presidential on down. With a plan centered around taking on the monopolies, there’s some hope for Democrats not only to undo the damage they’ve suffered in rural America, but also to set the stage for a broad populist-progressive alliance that, like the last one, could transform the country for the better.