These towns exist because they used to have jobs. Then those jobs dried up due to manufacturing leaving, companies dying and so forth.
These people can't up and leave because their homes are worth very little and they don't have the money or skills to pivot to anything new. So what else is there for them to do but nothing?
That's the reality of many small towns in America.
It's starkly obvious in New England outside the orbit of Boston. In the 90s, there were still many, many shoe shops, textile mills, clothing manufacturers, furniture shops and lumber and paper mills. And around those businesses were a whole constellation of other support industries. When the mills got outsourced to China, or Bangladesh or Mexico, everything else went down like dominos, and there's nothing left; in my hometown, people are struggling to hold on, with the school district, a small local university, the regional hospital, a ski resort, and yes, the Walmart, as the only large employers left. Nobody who gets an education ever comes back, so what's left is a shrinking, greying population.
Going back further in time, agriculture was once tenable, but refrigeration and processed foods largely killed the regional market, and trying to farm rocks in New England is much less efficient than doing so in the Central Valley or the Midwest.
These people can't up and leave because their homes are worth very little and they don't have the money or skills to pivot to anything new. So what else is there for them to do but nothing?
That's the reality of many small towns in America.