Personally my impression is this narrative has gotten worse not better of the last few decades as the political divide between "red states" and "blue states" have deepen, even if you live in a midwest "blue state".
Also by "are there buildings there" I would assume that a person on the east coast would be referring to Skyscrapers not just generalized building, which are quite rare in the mid-west.
My encounters with Coastal people generally result in them believing that the midwest is just farming and retail, Tech Jobs or other high income white collar jobs like Finance are not associated with the mid-west region...