Bill Barrow
In this Feb. 10, 2019, file photo Sen. Cory Booker, D-N.J., talks with Deanna Miller Berry in Denmark, S.C. Several Democratic presidential candidates are trying to make a play for rural voters. Booker has traveled to small towns in South Carolina and New Hampshire and told voters that he hears some of the same concerns from them that he hears in his hometown of Newark, N.J. (AP Photo/Bill Barrow

DENMARK, S.C. — Deanna Miller Berry doesn't often see presidential candidates. So when New Jersey Sen. Cory Booker recently came to Bamberg County, South Carolina, she was primed to unload about a contaminated water system.

"What is your plan to fix it?" Berry asked, her eyes narrowed.

Booker, former mayor of Newark, the largest city in the most densely populated state, assured Berry he cares about the 3,000 residents of Denmark, South Carolina. "This is a time in America where too many people are feeling left out, left behind, not included," he said, promising "a massive infrastructure investment" targeting "forgotten" places.

The exchange highlights the effort by Democratic presidential candidates to make inroads in rural America. With the first contests unfolding next year in South Carolina, Iowa and New Hampshire, small-town voters will play a critical role in choosing the next Democratic nominee. And the early attention could help the eventual nominee be more conversant on rural issues and compete for votes in places that gave President Donald Trump his most intense support in 2016.

"Organizing in every precinct is the key to winning both the caucus and the general election in Iowa," Iowa Democratic Chairman Troy Price said.

Vermont Sen. Bernie Sanders lamented rural decline during an Iowa swing this weekend.

"All over America, we have tragically seen more and more young people leave the small towns they grew up in, the small towns they love, because there are no decent-paying jobs in those towns — we intend to change that," Sanders said, drawing cheers at the Iowa State Fairgrounds.

At the same time, California Sen. Kamala Harris was in small-town South Carolina advocating more spending on telemedicine, broadband internet and infrastructure. Booker used his two-day rural swing last month to talk health care, housing, infrastructure and criminal justice, among other issues. New York Sen. Kirsten Gillibrand was the first candidate who ventured to rural northern New Hampshire. Minnesota Sen. Amy Klobuchar has already visited a tiny town in Wisconsin, which will be a general election battleground.

Several candidates plan to attend a March 30 rural issues forum at Buena Vista University in Storm Lake, Iowa — population 10,600.

The approach matters most immediately because the delegates necessary to become the nominee are awarded in part from primary and caucus results in individual congressional districts, even the most rural and Republican-leaning. But investing there also could narrow Republicans' general election margins, by increasing turnout among Democratic-friendly constituencies like rural black and Latino voters or peeling off white voters or both.

That could flip states like Iowa, Michigan, Pennsylvania, North Carolina — even Florida — that propelled Trump to an Electoral College majority. Besides helping win the presidency, rural gains would be necessary for Democrats to have the muscle on Capitol Hill to enact the kinds of sweeping policy changes they are advocating on many fronts.

"So much of this is about the margins," Iowa's Price said.

Beyond the politics, candidates say rural outreach is required of anyone who wants to govern a diverse nation.

"Folks want to be seen," Harris said. "They want their issues to be heard. ... They could care less about half the stuff that gets covered on cable news networks."

In Wisconsin, Klobuchar said, it's "about knowing the issues that matter to people whether they're Democrats, Republicans and independents — and in rural areas it's not just about the farm bill."

The 2018 midterms demonstrated Democrats' tough realities beyond metro areas, but still offered some bright spots.

AP VoteCast, a national survey of more than 115,000 voters, found rural and small-town residents cast 35 percent of midterm ballots; 56 percent of those voted for Republican House candidates, compared to 41 percent for Democrats. The advantage was wider among small-town and rural whites: 30 percent of the electorate, tilting 63-35 for Republicans. Correspondingly, Democrats' net 40-seat gain in the House was driven mostly by previously GOP-leaning suburban districts, while Democratic nominees fell short in more rural areas.

There's no consensus on whether rural success for Democrats is about policy or personality or some combination. Some winners establish a personal brand at odds with the national party — West Virginia Sen. Joe Manchin defending the coal industry, Ohio Sen. Sherrod Brown opposing much of U.S. trade policy, Montana Sen. Jon Tester playing up his rancher credentials.

But that won't necessarily work for a presidential candidate looking to become the face of a party with a decidedly liberal base. None of the declared candidates deviates from Democratic orthodoxy supporting abortion rights and LGBTQ civil rights and opposing Trump's hard line on immigration — all positions that run afoul of rural and small-town voters who collectively are more culturally conservative than urban dwellers.

Sanders struggled with that balance in 2016 when Hillary Clinton hammered him for some Senate votes against gun measures that most Democrats backed. Sanders noted that many Vermonters, as in the rest of rural America, view guns differently than most big-city residents, but Clinton successfully used the issue against Sanders, particularly with black women.

Would-be Democratic presidents are left to mix economic arguments with biography.

Washington Gov. Jay Inslee grew up in Seattle, but he often mentions that he spent his early adult years in central Washington. He touts his signature issue — combating climate change — as a boon for the "heartland" economy by growing the clean-energy industry.

Klobuchar, a Twin Cities-area native, points to her work on the Senate Agriculture Committee and notes she's won every congressional district in Minnesota during her Senate career. Sanders, who still speaks with his native Brooklyn inflection, drew roars in Iowa when mentioned using antitrust law to limit corporate power.

Harris notes that California — caricatured in Middle America as a bastion of coastal liberalism — has the nation's biggest agricultural output. And in South Carolina, she said she heard a lot about jobs and state Republicans' refusal to expand Medicaid insurance.

Massachusetts Sen. Elizabeth Warren notes that long before her Harvard law career, she was a child in Norman, Oklahoma, where her family's working-class struggles shaped her liberal approach to consumer, labor and finance law.

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After hearing Booker, Kenneth Belton, a 63-year-old resident of struggling Fairfield County, South Carolina, said a president doesn't have to come from his walk of life. Belton just wants the person in the Oval Office to understand him — and then to help.

"It just feels like they've been ignoring us," he said.

Berry, the clean water activist, agreed, crediting Booker and others for what she describes as first steps.

"I've heard enough to be inspired," she said, pausing before adding, "enough to want to hear more."

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Associated Press writers Sara Burnett in Chicago, Alexandra Jaffe in Des Moines, Iowa, Meg Kinnard in North Charleston, South Carolina, and Hannah Fingerhut in Washington contributed to this report.