For starters, many of the counties that "vote for the Republicans" are like 60-40 or 70-30 splits, so somewhere between a third and a half of the people living in those areas voted Democrat. And of course, many don't vote at all if they know their state is locked in for a given candidate regardless.
Second, there are myriad issues that due to America's 2-party system ultimately get grouped into relatively arbitrary bundles. If you have to choose between two bad options, you might choose the one that's less immediately bad or less guaranteed bad or less severely bad, even knowing that the alternative is future-bad, maybe-bad or slightly-bad.
Third, just have sympathy for all people in all walks of life. Especially the marginalized. You likely don't have an understanding of their day to day struggles or how those inform their decisions and coping mechanisms, and even if you are right and they are wrong, please take a moment to consider how your privileges may give you the education, time, energy, resources and context to come to different conclusions than other people.
Sure, or maybe they could think about the same things, like how they're white, and I'm not, and how they are men, and I'm not, and how they are cis, and I'm not, and how their parents were born here, and mine weren't.
Then they could very clearly not vote for politicians that are preying on their phobias who also happen to be making their healthcare worse and their lives harder.
These are the people that will vote in a fascist who explicitly voices xenophobic, homophobic, and transphobic opinions.
Very hard not to say "fuck 'em".
No candidate will ever match your views 100%, but which gets your vote shows your priorities.
I've convinced that there are many people that vote Republican even though they openly campaign on removing the social security and Medicare that they need to survive because they want to stick it to the LGBTQIA+ that they're disgusted by.
I personally know someone that is left by nearly every single measure. Wants medicare for all, higher minimum wage, higher taxes on the rich, reduced military spending, I could go on. But he voted Trump in 2016 because he absolutely hated the Social Justice Warriors on Tumblr that made everything a contest over who could be the most offended by the smallest thing. He was anti-woke before "woke" was even in the lexicon.
In a similar vein, the "socially liberal, but fiscally conservative" types that vote Republican are essentially sending the message that a tax cut for them is more important than minority issues. It's the ultimate "Fuck you, I got mine".
Fascinating concept, but one that will remain alien to me.
(Pregnancy suppresses the mother's immune system and thereby increases the risk of cancer -- a pregnant woman has something like a 0.1% chance of having cancer -- and many of the treatments either cause abortion or would seriously damage a fetus, making abortion necessary.)
Rinse and repeat
True, but you could also say the same in urban communities.
Is your lack of empathy an urban thing, or would you attribute it to something else?