Since Trump was elected U.S. President in 2016, researchers have sought to explain his support, with some focusing on structural factors (e.g., economics) and others focusing on psychological factors (e.g., negative emotions). We integrate these perspectives in a regional analysis of 18+ structural variables capturing economic, demographic, and health factors as well as the aggregated neuroticism scores of 3+ million individuals. Results revealed that regions that voted for Trump in 2016 and 2020 had high levels of neuroticism and economic deprivation. Regions that voted for Trump also had high anti-Black implicit bias and low ethnic diversity, though Trump made gains in ethnically diverse regions in 2020. Trump’s voter base differed from the voter base of more traditional Republican candidates and Democrat Bernie Sanders. In sum, structural and psychological factors both explain Trump’s unique authoritarian appeal.