Ronald Reagan summed up the feeling when he was president: "I've always felt the nine most terrifying words in the English language are, 'I'm from the government, and I'm here to help.' "But rural Americans have come across scarier phrases since then, like "the opioid epidemic.""So what you have are some very serious problems — particularly around the economy and opioid and drug abuse — that really worry people," says Robert Blendon, professor of health policy and political analysis at Harvard's T.H. Chan School of Public Health.Small towns face big problems. In rural America, rugged individualism is still prized, but so is the pragmatism that has begun to trump traditional disdain for government.Many rural communities are facing two big, persistent issues: drugs and economic stagnation. Take Belle, Mo., with its population of 1,500."Money is a big problem," says Kathy Stanfield, who is in her late 60s and raised her children here. "You don't have the tax base anymore that you used to have."Stanfield says Belle has struggled since the shoe factory closed decades ago. It was once the town's biggest employer.Increasingly, the town relies on grants to pay for basic maintenance, like replacing crumbling sidewalks or fixing faulty water lines. And that money is getting harder to come by.Belle has a drug problem, too, and Roxie Murphy, a newspaper reporter who covers Belle for the Maries County Advocate, says drug-related crime is on a lot of people's minds.