WARREN, United States — Former US steelworker Denise Barber retired three years ago, but steep gasoline prices and family healthcare needs are making the Ohio resident consider returning to part-time work to make ends meet.

The 68-year-old is among US voters squeezed by affordability worries ahead of November's midterm elections.

The Democratic former union worker was among dozens in Mahoning Valley — known for its industrial history — to show up at a town hall in recent weeks, expressing concern over hospital closures, cuts to health programs and rising cost of living.

Many districts in Ohio are expected to remain Republican. But the Buckeye State, which US President Donald Trump won by double digits in 2024, has become a battleground.

Democrats are competitive in some House races and have a chance of seeing former three-term senator Sherrod Brown unseat Republican Jon Husted, who filled a vacancy left by Vice-President JD Vance.

Affordability remains top of mind for US voters this year.

Some 29 percent spontaneously named an economic concern when asked what they wanted congressional candidates to discuss, a Pew survey in June found.

War with Iran has intensified stresses, as Tehran retaliated against US-Israel strikes from late February by choking off the Strait of Hormuz, sending energy costs soaring.

The average cost of regular gasoline has jumped over 45 percent since the war started, to $1.15 per liter, AAA motor club data shows.

For Barber, this sometimes meant hundreds of dollars more in weekly expenses.

"I'm going to have to find a job so that I can make up the difference," she said.

While Mahoning Valley in northeast Ohio has "become very Republican", Hudson Institute Nonresident Senior Fellow Paul Sracic believes the party faces "real danger" in the Senate race.

"The party in power always does poorly in midterm elections," he said. "It was going to be an uphill fight anyway." But "we have gas prices going up, and gas prices are the best measure of how people feel about the economy", he said.

"Affordability is affecting every worker, not only in this area but really across the entire country," said David Green, a labor leader with the United Auto Workers union in Ohio.

"Workers are getting crunched right now," he added.

"What's been really scary is over the last six months to a year, a lot of our smaller UAW facilities that are independent part suppliers, mom-and-pop shops, are having layoffs and some plant closures," Green said.

Retired steelworker Mike Rubicz has seen Mahoning Valley "go from one of the main centers of the steel industry in the world to (virtually having) no steel mills left."

While the area around Mahoning Valley such as the city of Youngstown was once predominantly Democrat, it turned red in 2016 amid Trump's election pledges.

Some residents say they are still awaiting the manufacturing resurgence Trump promised.

AGENCIES VIA XINHUA