The report commissioned by a group called 21st Century Democrats finds that factory towns like Ottumwa and Dubuque make up 40% of voters. Many of them voted for Barack Obama in 2008 and 2012, and Donald Trump in 2016.
John Pouland of the 21st Century Democrats suggests even if the party is fighting for workers' issues, it's failed to communicate that to voters.
"The issues that are important to Americans are Democratic issues. It's about wages and it's about jobs and opportunity and it's about education. The fact that we're not communicating that to voters in these factory towns--that's our fault."
The report looks at more than 800 counties in Pennsylvania, Ohio, Michigan, Indiana, Illinois, Wisconsin, Iowa, Minnesota, Missouri, and upstate New York. It found that since 2012, Democratic losses in these manufacturing counties outweighed gains in cities and suburbs by a 2-to-1 margin.
Pouland says the only way for Democrats to fix this is to win back voters in these counties inch by inch.
"Half of winning is showing up. We've got to start building an organization and recruiting candidates at the local level that will defend what we're doing and how it will make a difference in people's lives every day."
Pouland says Democrats have failed to understand the needs of millions of voters. He says whether it is the race for the White House or down-ballot, Democrats must think differently about how to stay viable in each community.