The former manufacturing backbone of the U.S. is in rougher shape than ever, still searching for some way to replace its long-stilled smokestacks. Where's it worst? Ohio has 4 of the 10 cities and Michigan has 2 cities making the ranking.

So far this decade, 115,000 people have left Cleveland. Smaller changes in other regions can be just as painful: People are leaving in the thousands and they are not being replaced by either new babies or new immigrants.

These cities face fleeing populations, painful waves of unemployment and barely growing economies... And they face even bleaker futures.

Once great centers of business and industry, these cities now are shells of their former selves. They will have to re-shape their image & think outside of the box in order to try to attract future residents and businesses.

The top 5 fastest dying American cities:

1. Canton, Ohio

2. Youngstown, Ohio

3. Flint, Mich.

4. Scranton, Pa.

5. Dayton, Ohio