Funny, that doesn't happen in other countries that use direct votes for their presidential elections.
Their aren't many other countries (if any) of our size with such free and fair elections to compare ourselves to.
Out of the five largest countries, four are democracies. India's larger than the United States, but it doesn't have direct presidential elections. Indonesia and Brazil, which are smaller than the United States (but not by that much) both do. In Indonesia in 2009, the election was certainly not dominated by cities; the winning candidate, Yudhoyono, won in urban and rural areas. In Brazil, both left-wing city-backed candidates and right-wing rural candidates have won.
In 2006, Lula won over 60% of the vote despite losing in Brazil's largest city and state (Sao Paulo). Lula also won more votes than Reagan did in 1984.