I don't think it is possible for the Democrats to win the rural vote, barring any unique factors like college town or demographics. The Democrat brand is just too toxic. No matter how much rural areas say they aren't interested in a culture war and just want rural healthcare and economic development (and how many urban/suburban Democrats are going to say no to increased health care spending to win votes?); those areas consistently vote against Democrats offering such things and vote for the party least open to such policies. Rather than organize and pressure their congresscritters into taking action on rural healthcare and economic development, it really seems to me rural areas are content to whine about culture war issues and how those darn Democrats don't represent my interests.