I'm not even sure what metric he is looking at when he says "the same ####holes they've always been." Statistically crime is down in all the large cities from where it was several decades ago. I'm assuming Chicago is one of the ####holes (the Rs seem to love to rag on Chicago ), and even though there is still way too much violence there, there are almost half the number of murders there per year than there were in the early 90s. You'll see similar statistics for pretty much all the major cities in the country. There may be an outlier or two. But I don't know if we are talking about crime.
If we are talking about poverty levels, I don't feel like looking it up, but if I did I'm sure I would find they have been decreasing as well.
Maybe he's just talking about litter and the cities being dirty in general. If he is I can point to various programs I am personally aware of that help make them cleaner.
But given that he's just making blanket statements and using subjective terms with no specifics, it's pretty hard to have a conversation about it. And I'll stand by the fact that declaring someone's home city a "####hole" is pretty offensive. I certainly wouldn't want to vote for someone telling me I lived in a ####hole that they needed to fix for me, while simultaneously knowing virtually nothing about it.