THE BURNED OVER DISTRICT

But all too often they get side tracked by things that seem important and distract the voters from what will really affect them when the winner takes office. The special Senate election in Alabama has a doozy of a distraction and the issues being ignored will hurt a lot of people.

The hospital here, the only one in the county, is planning to close this month.

The 9,000 or so people who are seen in Lakeland Community’s emergency room each year will have to go dozens of miles to Jasper or Russellville or Winfield. Eighty-seven people will need new jobs. Businesses are worried about their workers’ compensation premiums rising, and how this city of about 4,100 people will attract anyone without a hospital to help them once they are here.

“It’s a dire situation if that hospital closes,” said Holly Watkins, a real estate agent who was shopping on a downtown block already dotted by empty storefronts. “The hospital closing is the No. 1 issue.”

But during the United States Senate race that will culminate on Tuesday, the sensational has overshadowed the myriad problems in one of the nation’s poorest states. And as voters prepare to cast their ballots, they often lament the issues that have fallen outside the spotlight’s glare during the nationally watched campaign between Doug Jones and Roy S. Moore.

Those issues are still haunting Alabama in a race that has revolved almost entirely around Mr. Moore’s extreme views and the allegations against him of improper behavior with young girls.

Polls suggest that about half of the voters believe that the accusations of sexual misconduct against Mr. Moore, the Republican nominee, are not the most important issue in the race. For every voter who calls the allegations crucial, there is another who worries more about education, health care, job creation, same-sex marriage, race relations or the state’s roads and bridges.

The state is so often stellar in football, residents say ruefully, and not much else, a consequence of generations of bitter fights, political turbulence and eternal divides over race and class.

About 17 percent of Alabamians live in poverty — the fifth-highest rate in the country — and the state’s violence-wracked prisons are jammed to 159 percent of their intended capacity. With budget troubles a chronic fact of life, spending on Medicaid, which has not been expanded, lags. Standardized test scores are among the nation’s lowest. Heart disease and diabetes are endemic.

Last year, Marion, a rural city in central Alabama, suffered a tuberculosis outbreak so severe that its incidence rate was worse than that of many developing countries.

The infant mortality rate for 2016 rose to 9.1 deaths per 1,000 live births, the highest rate the state has seen since 2008. (The national rate was 5.9 deaths per 1,000 live births in 2015, the most recent year for which federal data is available.) The mortality rate was more than twice as high for black infants as white ones, and in some parts of the state, like Perry or Pickens Counties, the rate was 25.6 and 30.3.

“I think we really don’t know why it’s going up,” said Grace Thomas, the assistant state health officer for family health services with the state’s Department of Public Health, who called the rates a “key indicator of a health care system’s effectiveness” and said black, Hispanic and poor women were less likely to get the care they need.

Paris Daves, 24, said it took her several months after she found out she was pregnant last year to get on Medicaid, although she has since drawn support from an organization called Gift of Life, which works to prevent infant mortality in Montgomery. But as a young, single parent, there are other problems, too, like unreliable public transportation and low wages.

Just some of the many problems in Alabama that need fixing and no one Senator can do it but with too little discussion of the problems comes too little action. And in Alabama about the only action in the state happens on the football fields.