Where’s it worst? Ohio, according to our analysis, which racked up four of the 10 cities on our list: Youngstown, Canton, Dayton and Cleveland. The runner-up is Michigan, with two cities–Detroit and Flint–making the ranking.

These, and four other metropolitan statistical areas, as defined by the U.S. Census Bureau, face fleeing populations, painful waves of unemployment and barely growing economies. By our measure, they’ve struggled the worst of any areas in the nation in the 21st century. And they face even bleaker futures.

Another brutal statistic all the cities share is a diminishing population. So far this decade, 115,000 people have left Cleveland, for other climes. Smaller changes in other regions can be just as painful. Nearly 30,000 people have left Youngstown, Ohio, and they aren’t being replaced by either new babies or new immigrants.

Still, the cities we found to be struggling don’t vary widely by age, and this factor had little influence in the rankings. The oldest city in our top 10, Scranton, Penn., had 45% of its population over 45; the youngest, Flint had 38% over 45.

The worst news is, of course, economic. When we looked at the most recent gross domestic product estimates for 155 metropolitan statistical areas estimated to have $10 billion or more GDP in 2005–economies about the size of Asheville, N.C., or Tallahassee, Fla.–the news was predictably terrible for the Rust Belt.

But yet, the voters in these areas latch onto the candidate that promises the best scenario and yet nothing has changed.  Go figure!