– 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 dotted by empty storefronts. “The hospital closing is the No. 1 issue.”

But during the Senate race that will culminate 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 race between Democrat Doug Jones and Republican Roy Moore.

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

Polls suggest that about half the voters believe that the accusations of sexual misconduct against Moore 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.

“Alabama voters do care about infrastructure, health care, the military,” said Paul DeMarco, a GOP state legislator until 2014. “Those issues are important, but they’ve gotten drowned out with the headlines of the past 30 days.”

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.

Paris Daves, 24, said it took months after she found out she was pregnant last year to get on Medicaid, though 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.

“Minimum wage here is $7.25,” said Daves, who earns a dollar more than that as a shift manager at McDonald’s. “That’s not enough to pay my rent or take care of my son.”

In Haleyville, northwest of Birmingham, the coming shutdown of the hospital looms over the city where, in 1968, the country’s first 911 call was made.

“There’s really no other way to put it than a missed opportunity,” said Will Walker, a bank president in Haleyville, the largest city in a county where President Donald Trump won 90 percent of the vote last year. “We’ve had so little discussion about issues, it’s disappointing.”