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You are beyond ill informed. The huge majority of middle American housing is located in areas with much better air quality than any of the big coastal cities like Los Angeles.

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I thought we were talking places where people can work/live. Detroit came to mind: affordable housing, a few jobs- not many. But then I remembered: oh yeah! They have a giant trash incinerator blowing poison air on the whole Metro Area. It is at its worst where the housing is at its most affordable. Then I thought Indiana, Ohio- also having cities with some of the worst air quality in the country. Detroit's is worse than LA. Evansville is up there. Let's not even start with the water issues in the midwest, starting with Detroit.

https://www.theguardian.com/us-news/2016/oct/23/detroit-garb...

Detroit is one of the worst in America and being nearly on the Canadian border, I don't think many consider it "middle" America.

Middle America is more socioeconomic than physical. Chicago, south of Detroit (but mostly just further from the border with Canada), wouldn't be considered Middle America. North Dakota probably would. Detroit is a strange city, but I think many people would probably refer to it that way. The midwest in general can conjure some of the aesthetic pretty well, despite physical locations sometimes being quite north.

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