I live in the upper Midwest. A growing number of small towns have evolved away from the "town center" model, and now have a mostly vacant / decaying downtown, and strip malls anchored by big-box stores, at the edge of town. Or, the same thing but with the stores in a neighboring town. In other words, the small towns have re-structured themselves as suburbs without the urb.

The exceptions are towns with a hospital or college that can retain some vitality in the downtown area.