Rural Appalachia still needs a

July 26, 2004 7:36 AM

Backyard Third World

John F. Kennedy saw it and pronounced it a shame on our nation. Lyndon B. Johnson tried to change it. The "compassionate conservatives" have exacerbated it. I wanted to share it with you. Isn't it time for real change? Hasn't the exploitation of this place and these people gone on long enough?
posted by nofundy (34 comments total)

Hasn't the exploitation of this place and these people gone on long enough?

You're damn straight it has. Very few regions have been consistently brutalized as West Virginia. Quite frankly the treatment of the people of that state and the rest of Appalachia is disgraceful.
posted by jonmc at 7:51 AM on July 26, 2004

My husband was at this fair, trying to get eligible families signed up for FAMIS. He goes to two or three of these every year, one or two in Appalachia and another on Virginia's eastern shore. Yes, there are many impoverished people there; but they come from all over the region. They are not representative of the entire populace, just an incredibly underserved portion.

John F. Kennedy saw it and pronounced it a shame on our nation

Dear JFK rolled back into the hills and said, "Look at the poor hillbillies. Shouldn't we help them?" As my father always notes, he could just as easily have gone into the ghettos of Boston and found some needy people there. JFK's efforts cemented the impression in America's mind that Appalachian people are uneducated, dirty and uncared for. I'm sure there are poor people in Boston who've never seen a dentist either, but those folks never become the butt of jokes on late-night television.

As a native Appalachian, I have mixed feelings about sentiments like yours, nofundy. On the one hand, it's always good to see "the outside world" pay attention to our little region in a context other than Deliverance cracks. But our poor people are no different than the poor people in the other 49 states. Wal-Mart is exploiting workers in Nevada just as shamefully as in Virginia & West Virginia. 44 million Americans lack health insurance, and only a fraction of them live in Appalachia.

Your title says it all: Backyard Third World. When is America going to stop treating Appalachia like we're too poor and ignorant to take care of ourselves? We're suffering in the same way the rest of the nation suffers. Give us a robust domestic economy, give us nationalized health care, give us increased education spending and we - along with everyone else - will thrive.
posted by junkbox at 8:02 AM on July 26, 2004

consistently brutalized as West Virginia

nitpick: the article is about Virginia, not WV, though the gist is still the same.
posted by dhoyt at 8:08 AM on July 26, 2004

Give us a robust domestic economy, give us nationalized health care, give us increased education spending and we - along with everyone else - will thrive.

Exactly.
posted by amberglow at 8:29 AM on July 26, 2004

From Juan Cole's Informed Comment


Reagan had an ability to project a kindly image, and was well liked personally by virtually everyone who knew him, apparently. But it always struck me that he was a mean man. I remember learning, in the late 1960s, of the impact Michael Harrington's The Other America had had on Johnson's War on Poverty. Harrington demonstrated that in the early 1960s there was still hunger in places like Appalachia, deriving from poverty. It was hard for middle class Americans to believe, and Lyndon Johnson, who represented many poor people himself, was galvanized to take action.

I remember seeing a tape of Reagan speaking in California from that era. He said that he had heard that some asserted there was hunger in America. He said it sarcastically. He said, "Sure there is; they're dieting!" or words to that effect. This handsome Hollywood millionnaire making fun of people so poor they sometimes went to bed hungry seemed to me monstrous. I remember his wealthy audience of suburbanites going wild with laughter and applause. I am still not entirely sure what was going on there. Did they think Harrington's and similar studies were lies? Did they blame the poor for being poor, and resent demands on them in the form of a few tax dollars, to address their hunger?

posted by jmgorman at 8:42 AM on July 26, 2004

While you're thinking about it, remember that The Lions want your unused eyeglasses.
posted by grabbingsand at 8:49 AM on July 26, 2004

No offense meant junkbox, as you make some fine points, but the vast majority of americans living under the poverty line are in fact the rural poor:
At the county level, poverty rates were highest in rural areas in the Midwest and South, particularly in Central Appalachia, the Northern Plains, the Lower Mississippi Valley, and in the Rio Grande Valley in southern Texas and New Mexico.

Like I said, you make a good point about people painting everyone in the region with the same stereotypes, and certainly there is poverty in boston (DC is a better urban example), but appalachia is one of the hardest hit regions.

It's all very surprising after all, the republicans and clinton democrats told us getting rid of welfare would stop the cycle of dependency that was the real cause of poverty. Guess they were wrong. Go figure.
posted by malphigian at 8:53 AM on July 26, 2004

the vast majority of americans living under the poverty line are in fact the rural poor

I wouldn't disagree with that statement at all - my point about Kennedy and Boston was simply to emphasize the fact that he needn't have traveled so far to find people in poverty. Appalachia is convenient for politicians to point to as a poster-child for neediness because it allows them to highlight poverty without getting their coat tails dirty. "Look! There are poor people! Back there in the mountains far away from my home district!" It creates the comforting illusion that poverty in America is isolated rather than pervasive.
posted by junkbox at 9:12 AM on July 26, 2004

Junkbox's post got cut off in IE. Here's the text of the comment:

My husband was at this fair, trying to get eligible families signed up for FAMIS. He goes to two or three of these every year, one or two in Appalachia and another on Virginia's eastern shore. Yes, there are many impoverished people there; but they come from all over the region. They are not representative of the entire populace, just an incredibly underserved portion.

John F. Kennedy saw it and pronounced it a shame on our nation

Dear JFK rolled back into the hills and said, "Look at the poor hillbillies. Shouldn't we help them?" As my father always notes, he could just as easily have gone into the ghettos of Boston and found some needy people there. JFK's efforts cemented the impression in America's mind that Appalachian people are uneducated, dirty and uncared for. I'm sure there are poor people in Boston who've never seen a dentist either, but those folks never become the butt of jokes on late-night television.

As a native Appalachian, I have mixed feelings about sentiments like yours, nofundy. On the one hand, it's always good to see "the outside world" pay attention to our little region in a context other than Deliverance cracks. But our poor people are no different than the poor people in the other 49 states. Wal-Mart is exploiting workers in Nevada just as shamefully as in Virginia & West Virginia. 44 million Americans lack health insurance, and only a fraction of them live in Appalachia.

Your title says it all: Backyard Third World. When is America going to stop treating Appalachia like we're too poor and ignorant to take care of ourselves? We're suffering in the same way the rest of the nation suffers. Give us a robust domestic economy, give us nationalized health care, give us increased education spending and we - along with everyone else - will thrive.

posted by junkbox at 8:02 AM PST on July 26

posted by PrinceValium at 9:16 AM on July 26, 2004

junkbox ... thank you for telling it like it is clearly ... there are parts of n michigan that are just as desperately poor as rural virginia ... for years, i was one of the working poor ... and for people like us, it's an entirely different country ... one in which we do the jobs that need doing and are treated with contempt and loathing by many of our "betters"

in addition to what you think we should give, i would say, give us respect for the work we do for you
posted by pyramid termite at 9:22 AM on July 26, 2004

I spent some time in West Virginia building houses for Habitat for Humanity, and was stunned by the poverty I saw.

Junkbox: You're quite right in thinking that poverty of a similar level exists in large urban centers. Living in Chicago, I see it every day on my commute to work. There is, however, a fundamental difference - urban centers provide some measure of health care (Cook County hospital here in Chicago, for instance) and some social services. Both of which seem absent in rural Appalachia (or, after reading pyramid's comment on preview, rural areas throughout the country).

On a side note: The article mentions coal miners who have made the switch to Wal Mart. It made me realize that the uber-retailer employes some of the same tactics as the old mining companies. Slave wages, a certain indebtedness to the "company store" etc. It's the same demon, only above ground and in cleaner clothing.
posted by aladfar at 9:25 AM on July 26, 2004

This was a pretty generalized, emotionally manipulative article, almost entirely without specifics. The only serious condition mentioned was that woman's cervical cancer. Was there pervasive high blood pressure, heart disease, other types of cancer? The only other disease we hear about is tooth decay -- an easily preventable problem. I'd like to hear a breakdown of what diseases and disorders they found in this population. How many are easily and inexpensively addressed by prevention? Before we nationalize health care and sue Wal-Mart, how can we get poor people to make sensible lifestyle choices?
posted by Faze at 9:36 AM on July 26, 2004

It's very common to see women who have not had a Pap smear to detect pre-cancerous abnormalities "in 10, 15, 20 years," Hullfish said.

WHAT. THE. FUCK?!

That is beyond appalling.
posted by five fresh fish at 9:37 AM on July 26, 2004

how can we get poor people to make sensible lifestyle choices?

Simple. Give them easy, affordable access to preventative health care services. Poor people are not the only ones who eat junk food and fail to floss regularly. They just don't have the luxury of seeing a doctor or a dentist who will regularly tell them, "Flossing prevents tooth decay. Excercise will help your high blood pressure."

Seriously, handing somebody a packet of dental floss and a brochure about nutrition is not going to make up for the fact that he has a menial job that doesn't allow him to afford health insurance. This article is not exaggerating the level of need; some of these folks drive 100-200 miles from other states like West Virginia and Kentucky to attend.
posted by junkbox at 9:53 AM on July 26, 2004

Errr...wasn't it Robert Kennedy, not JFK, who went to Appalachia and had the scales drop from his eyes?
posted by cookie-k at 10:00 AM on July 26, 2004

"The article mentions coal miners who have made the switch to Wal Mart. It made me realize that the uber-retailer employees some of the same tactics as the old mining companies. Slave wages, a certain indebtedness to the "company store" etc. It's the same demon, only above ground and in cleaner clothing."

You're hitting very close to the root cause of this abject poverty. The place and people have been exploited by coal barons for a century with NO local investment. We're talking very large sums of money. The area would have been better off without the resource and its natural beauty would not be spoiled by mining activities as it is today.

No, cookie-k, I correctly referred to John Kennedy. Here's a link.
posted by nofundy at 10:28 AM on July 26, 2004

The only other disease we hear about is tooth decay -- an easily preventable problem.

Easily preventable - yes, being prevented - no. Which seems to be kind of the point. It may seem trivial to you but I'm betting eating is a whole lot less fun if all you have left is gums, or if your mouth is full of abscesses, exposed nerves etc.
posted by biffa at 10:37 AM on July 26, 2004

some of these folks drive 100-200 miles from other states like West Virginia and Kentucky to attend.
Junkbox -- if they're willing to go to all that trouble to attend a glorified health fair, why can't they go to the trouble of flossing and brushing every day? You'd think having a menial job and no health insurance would motivate you to brush and floss, test for cervical cancer, eat a healthy diet, etc. Oh yeah, and NOT SMOKE. How is this the fault of the coal bosses? If you don't wear seatbelts and are injured in a serious accident, whose fault is that? Is it the fault of your menial job? The same might be said to be the case with other simple preventive activities, like laying off the pork rinds and getting a little exercise.
posted by Faze at 11:36 AM on July 26, 2004

Did they blame the poor for being poor, and resent demands on them in the form of a few tax dollars, to address their hunger?

Yep. Spot on. This describes the feelings of quite a few Republicans and Right-Libertarians in the US today (note: not all Repubs or Libs mind you). The thought that a buck or two a year might come out of their pockets to help feed the hungriest denizens of the nation sends their blood pressure through the roof. I'm afraid I may never comprehend why, despite countless conversations, and a lot of genuine effort on my part to grasp their perspective.
posted by Fenriss at 11:45 AM on July 26, 2004

I am all for personal responsibility, but there are many people in this world that are not educated enough to know about proper diet, exercise, and oral care.

The number of people who really don't know much about how to take their medications, folklore about diseases, superstitions about how to prevent disease is not limited to these rural areas, but can be especially dangerous there due to lack of available education in those areas.

Just ask a nurse, they will tell you all sorts of stories about what people believe medically that will make your hair curl. (Pills go in your mouth, creams go on affected areas, not vice versa)
posted by jopreacher at 12:02 PM on July 26, 2004

Junkbox -- if they're willing to go to all that trouble to attend a glorified health fair, why can't they go to the trouble of flossing and brushing every day?

Because our country fails to teach and practice the philosophy of short-term sacrifice for long-term gain. So many poor people in our country don't know how to use our health care system properly, showing up at emergency rooms for sore throats and the like - but that's a problem not unique to Appalachia. There are entire non-profit organizations dedicated to improving this.

Many of the people who attend the health fair drive so far because they CANNOT get health care in their own town for one of several reasons:
a) there are no doctors, dentists, gynecologists, etc...
b) they have no money to pay a doctor or a dentist
c) they have Medicaid, but no doctor or dentist in their area will accept new Medicaid patients.
posted by junkbox at 12:03 PM on July 26, 2004

Faze, why do you presume these people lack personal responsibility, when they obviously present evidence by way of their taking advantage of attending the medical fair?

It seems to me that if they are willing to make such an effort as to drive several hundred miles to get medical care, there must be a more sensible explanation for the state of their health than "they just don't care."

I think brushing them off as retarded yokels who just ain't got the god-given brains or motivation to do something as obvious and simple as toothbrushing is unfair and illogical, though dreadfully easy.

Let's try for a more complete answer, shall we? Let's start with junkbox's conclusions, f'rinstance: that the system is failing them.
posted by five fresh fish at 12:40 PM on July 26, 2004

The thought that a buck or two a year might come out of their pockets to help feed the hungriest denizens of the nation sends their blood pressure through the roof. I'm afraid I may never comprehend why, despite countless conversations, and a lot of genuine effort on my part to grasp their perspective.

Mind you, this is not a belief I share, but near as I've been able to ascertain, it's a misguided resentment. An idea that they are working hard to give the gov't money that they give away to people who don't work and don't want to, which strikes at the heart of the work ethic by which many Americans help define themselves.

This belief is fed by propoganda highlighting those who do abuse the welfare system, but spreding the misguided message that they are the majority of aid recipients. Add that to the fact that generally speaking, nobody really likes paying taxes and you've got a big pile of resentment that politicians will use to their advantage.

I think we need to come up with counterpropoganda quite frankly.
posted by jonmc at 1:04 PM on July 26, 2004

I think we need to come up with counterpropoganda quite frankly.
posted by jonmc at 1:04 PM PST on July 26

People welfare works, corporate welfare doesn't?
posted by nofundy at 1:12 PM on July 26, 2004

Well I was thinking more like "Send my taxes to my hungry neighbor, not my fat-cat boss." But the sentiment is there.

But aid money is only part of the problem. I don't like setting up a state of permanent dependence either. Working to get jobs and business to the reigon is important, too.
posted by jonmc at 1:16 PM on July 26, 2004

five fresh fish -- I'm not saying that they're dumb yokels. I'm saying that maybe the answer is not all these vague socialistic suggestions that jonmc and others are making here, but some kind of relatively inexpensive educational efforts. If you object is to help the poor rather than punish the rich, you might want to start there.
posted by Faze at 1:58 PM on July 26, 2004

Metafilter: the first I've ever been called both a "neo-con" and "vaguely socialistic."
posted by jonmc at 2:06 PM on July 26, 2004

Not dumb yokels, but in need of an educational effort, eh?

I think the problem is likely far more complex than has been made out here. I think there are probably three factors at work:

a local society that doesn't hold with preventionary action, ie. brushing your teeth, keeping away from fatty foods, etc.

a local lack of medical facilities and/or the means to afford them.

a local lack of health information, ie. the importance of PAP smears after age 40.

These three factors together make it rather unlikely that they get the health care that most of the rest of us take for granted.

posted by five fresh fish at 2:30 PM on July 26, 2004

five fresh fish -- I'm not saying that they're dumb yokels. I'm saying that maybe the answer is not all these vague socialistic suggestions that jonmc and others are making here, but some kind of relatively inexpensive educational efforts. If you object is to help the poor rather than punish the rich, you might want to start there.

Why are we presuming that the only health issues that the rural poor will have are tooth decay and cervical cancer? I imagine they get sick for a huge number of reasons, preventable and not, just like everyone else.
posted by Summer at 2:57 AM on July 27, 2004

There's the jonmc I admire! Thanks for the analysis. I think you are quite right about the reasons behind the welfare resentment. As someone who has worked since I was 15 and has never accepted "government hand outs" (unless you count public schools) I can almost grok this. If there really are fat, happy welfare queens laughing all the way to the bank with their checks, then that's irksome. But I simply don't believe that's a significant demographic. I think most people would much rather not have to live on meager government scraps, and provided that their mental health is sound, would prefer to be doing something productive. So I agree with your opinion that programs to create jobs and strengthen small business need to be a big part of the equation.

Counterpropoganda: How about we create a vivid image of a world where every rich person has about 50 yards of nice road in front of his house, and every convenience store gets knocked over by starving, uneducated laborers on a daily basis? I find that pretty compelling.

As a friend of mine once said "there are no Libertarians in pot-holes".
posted by Fenriss at 7:45 AM on July 27, 2004

As someone who has worked since I was 15 and has never accepted "government hand outs" (unless you count public schools) I can almost grok this. If there really are fat, happy welfare queens laughing all the way to the bank with their checks, then that's irksome.

I starting working at 15, too, so I know where your coming from and I was raised to believe that all work is honorable and dignified.


But I simply don't believe that's a significant demographic.

Not large, no, but visible. And it touches a nerve with peoples pride. I remeber an aunt of mine descibing the gangsters who lived in her neighborhood as "men with soft hands" who "never got up before noon." I've actually heard the loudest resentment coming from people who could be desribed as "working poor."

But, ultimately, I don't believe people should starve or go without basic health care in this country, because we've got the means to make sure it dosen't happen. But I also believe in the work ethic and that it is preferable both for the aid recipient and society in general to make efforts to turn them into contributing taxpaying citizens.

When the mines were going full blast, people in some parts of West Virginia were doing okay thanks to strong unions. Same with autoworkers in Flint, and steelworkers in Pittsburgh. But those jobs have been shipped off, in many cases simply to marginally improve the bottom line for upper management and stockholders. And it's not just heavy industry. 2 years ago, me and my dad, who both worked in retail sales at the time (for different large companies) sweated through a couple rounds of company wide layoffs. When there's a decreasing pool of jobs to send people to, transforming welfare to work becomes difficult. Somehow or another we have to make it attractive not just for small business, but for large businesses to behave ethically.
posted by jonmc at 8:28 AM on July 27, 2004

I might add, the public perception of poverty and "government handouts" has changed a lot over the past 4 decades. My father grew up in New York City and his high school was across the street from a housing project. He told me that back then "the projects" did not have the same connotation it does now. Back then, it was fairly evenly racially mixed, most residents worked, it was considered a springboard to the middle class for the working poor. Several projects in New York, like Stuyvesant Town and Co-Op City were specifically geared towards ownership and working families just to this end and they were successful and people are still trying to get housing in them today.

Now projects have transformed into reservations of poverty that nobody wants to go near, and have become associated with crime and the "permanent underclass."

Author Richard Price who grew up in Baychester Gardens and Co-Op City in the Bronx talks about this in the latter half of this audio interview from his Times Page.
posted by jonmc at 8:53 AM on July 27, 2004

Lifestyle choice is a red herring. People who brush and floss everyday still get cavaties, though floridated water does help. The difference is that if you can afford to see a dentist every year (or more often, as they seem to be reccomending now), the small hole will be filled without too much damage. But if you can only afford to go every few years, the cavaties will have spred to the point where you need to have teeth pulled. My mother lost several teeth because she was without dental care for about a decade. It was only after changing jobs to one with dental benefits that she could afford to go for the checkup to find out that she had cavaties. Maybe if someone invents some kind of home cavity check, that could replace a dentist - I know I need one. (It's been over a decade since I've seen a dentist as well, through lack of coverage and lack of money).

The cervical cancer example from the article works on the same principle, but with more dire results. Cervical cancer just happens - but with early screening can often be found before it becomes serious. There isn't a life style choice that can help prevent cervical cancer, except getting regular pap smears. The article did not say that the women need to be educated about pap smears, but that they did not have access to them. It doesn't matter how much preventative health education you give if they cannot afford to follow the advice. Nor will education stop children and adults from needing glasses (actually, reading and computers probably causes some of this), and they can cost over $100 a pair. And that is with the frames from the cheapest, or free rack. Education is a powerful prevention tool in health care, but it cannot replace simple preventative care, like checks. Waiting just increases the costs for the whole of society.
posted by jb at 9:26 AM on July 27, 2004

there's something to be said for the welfare money that keeps them too drunk to find the trailer door.
posted by quonsar at 10:23 AM on July 27, 2004