You're just talking about rural regions now
Multiple grocery stores in hometown & where I attend uni
Multiple providers, even get 30/10 in hometown w/ 3000 people and no larger towns for 40 minutes
Can order pizza in hometown and uni town
While hometown doesn't have a craigslist, there is local communities that have facebook pages and serve similar purposes. Uni town has craigslist.
Small town schools can be pretty bad, but that's not uniquely midwestern.
I can handle a city and I do, some people like to not have to drive half an hour to work and having to live in suburbia.