President Trump’s so-called “America First” budget actually puts millions of Americans last. Calling for a $54 billion increase in defense spending and a corresponding $54 billion cut for non-defense domestic agencies and programs in FY2018, this “America Last” budget cuts or entirely eliminates critical investments in infrastructure, science and technological research, community development in rural and metropolitan communities, clean air and water, and the health and education of American families.

America’s rural communities have long faced challenges with access to affordable health care insurance and services. Doctors and hospitals are farther away, higher poverty rates lead to worse health outcomes and lower coverage rates, and older populations result in more expensive coverage pools.

President Trump told the nation’s governors last month that “we’re going to start spending on infrastructure, big.” But so far, the Trump Administration’s only action has been to release a budget that slashes funds for roads and bridges, train service, airports and water systems.

These state economic snapshots survey the economic situation on the ground in all 50 states and the District of Columbia. Although the U.S. economy overall continues its expansion from the Great Recession and associated financial crisis, the recovery can look very different from state to state, and even county to county. While some areas of the country have surged ahead, some regions are still struggling to regain their economic footing.