But in the last few years, in places across eastern Kentucky and especially in Whitesburg, young people have started returning. A record store co-op recently opened in town and holds events with musicians. A new tattoo parlor—started by a local man who returned from living in Louisville—draws people from across state lines and even other countries. When the city voted to allow restaurants to serve alcohol in 2007, two new bars opened. Three years ago, voters decided to let stores sell alcohol too. Last fall, the city council narrowly approved a permit for a moonshine distillery that's going to open in a historical building in Whitesburg's downtown.

Other recent additions include a cupcake store and a vape shop. But perhaps more important than the brick-and-mortar businesses is the sense among locals that there’s a growing commitment to staying in Appalachia.

“I knew I wanted to be in Whitesburg,” John Haywood, who owns the tattoo parlor, told me in his colorful basement shop decorated with his own artwork on the walls, which he opened four years ago. “There was what was to me a real grassroots movement here, still very early in its infancy, of just a lot of individual people trying to make stuff happen.”

Whitesburg is unique in that it has a history of arts and culture bolstered during the 1960s. In that way, it is perhaps better poised to make a comeback than other regions of eastern Kentucky, including Owsley County, often mentioned as the poorest county in America. One-quarter of the residents in Letcher County, where Whitesburg is located, live below the poverty line, as opposed to 38 percent of Owsley County residents.

Still, dozens of regions across the country have struggled through the loss of major industries such as mining or manufacturing. Few were as poor as Appalachia when the decline began. If Letcher County can find a way to not only survive the decline of coal, but thrive despite it, other regions in Kentucky and in the nation may be able to as well.

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There are many explanations for eastern Kentucky's poverty.

Perhaps the most famous account comes from Harry Caudill, an outspoken lawyer from Whitesburg who served in the Kentucky House of Representatives and then became a professor of Appalachian Studies at the University of Kentucky.

In an article, “The Rape of the Appalachias,” published in The Atlantic in 1962, he wrote of remote mountaineers in eastern Kentucky who were isolated from the industrial revolution and lived a life of hunting and trapping until after the Civil War. When outsiders started to come into the region, though, those locals were “putty in the hands of the Eastern capitalists,” he wrote (one imagines Daniel Boone meeting the Monopoly Man, who is cruelly twirling his mustache). The industrialists who came into the region in the beginning of the 20th century tore the trees off mountains, and then set to stripping the mountains of coal. The mines caused environmental problems such as flooding and pollution, which local counties had to pay to repair, Caudill wrote. After the companies were finished with the mines, they often didn't have to pay taxes on the land, depriving the local counties of tax revenues.