INEZ, Ky.— Martin County is nestled into the green, rolling hills of Appalachia, a two-city enclave that sits a stone's throw across the Tug Fork River from West Virginia .

Established long ago as coal country, the rural community is home to myriad hollows and approximately 11,500 residents , and is the country's worst-performing county with an above-average share of white residents in a U.S. News Healthiest Communities analysis of race, ethnicity and place in America. A longstanding mindset among area residents is to hope for more but accept poor outcomes, making positive change a difficult prospect.

"One of the things in living in Appalachia, being from here, is that growing up you saw this world on the outside ... you saw this world with nice homes, manicured lawns, sidewalks and things like that," says Gary Ball, editor of local newspaper The Mountain Citizen. "And growing up here, you just didn't see that. That was the outside world, and I think a lot of people in Appalachia still feel that way."

President Lyndon B. Johnson shined a harsh spotlight on Martin County in 1964, with a visit to plug his national War on Poverty . And despite having a population that's more than 90 percent white – a strong predictor of a community's overall health and well-being, according to the Healthiest Communities analysis – the county's image hasn't improved much since then. It's been hammered by one thing after another, including a water crisis that's spanned nearly two decades, high poverty rates and the national opioid epidemic .

In an overall assessment of nearly 3,000 communities nationwide across 10 categories and dozens of metrics tied to a community's health and well-being, Martin County is among those at the bottom of the pack with a score of 13.3 points out of a possible 100. In areas that are typically strong for very white communities – such as measurements of air and water quality and housing vacancies – Martin fares poorly. It achieves one of its lowest Healthiest Communities scores in the economy category, thanks in part to high unemployment and a lack of job diversity, while it also struggles in more traditional health indicators like smoking rate, obesity prevalence and overall life expectancy.

Despite what the statistics show, though, current and former residents say Martin County can thrive. Pointing to the potential of its industrial park, increased awareness about its water and infrastructure issues, and the construction of a new county high school – along with the inherent resilience of its residents – locals say opportunity exists for an Appalachian transformation.

It just needs to be taken.

"This is not one of those things that our entire existence is based upon how bad the statistics are," says Joshua Ball, the newspaper editor's son and an associate executive director of Shaping Our Appalachian Region , or SOAR, an economic development organization that works in the area. "We want to move, we want to change the narrative, but in doing that, we have to address some of the statistical challenges, and I think it's happening."

The Community That Could Be View All 18 Images

A New-School Era

Progress at Sheldon Clark High School within the last decade marks a step in flipping those statistics.

"If we want to look at what is reforming Martin County, it's the education. We have an excellent education system, and our kids are – I can't even begin to say how resilient our students are," says Marcie Hanson, who has worked at the high school for 24 years and teaches a school-to-work transition program.

Sheldon Clark, located in Inez and the county's only traditional public high school, was among the lowest-achieving in the state roughly a decade ago, with only seven seniors reportedly deemed college-ready in 2009 and a college and career readiness rate of 19 percent in 2009-2010. By 2016, the school had earned a " distinguished " classification. Nearly 60 percent of graduates that year earned college credit before getting their diploma, and 70.5 percent were considered ready for college, a career or both as defined by the state's Department of Education – higher than the statewide marks of 49.2 percent and 68.8 percent, respectively.

Meanwhile, nearly three-quarters of the Class of 2016 qualified for free or reduced lunch – a marker of the county's persistent poverty. Census estimates show the median household income in Martin County is approximately $29,052, roughly half the national mark , and more than 30 percent of people there live below the poverty line.

Martha Williams, a former nurse, became the principal at Sheldon Clark in 2017 and still oversees the Martin County Area Technology Center – a secondary institution offering job-training courses in fields like nursing, business and carpentry, and an example of Kentucky's statewide Career and Technical Education efforts to prepare students for their post-high school futures. She says the high school's improvement reflects an ongoing effort to teach students they can rise above the adversities that come with growing up in "a high-poverty, high-drug area."

"We let them know just because of adversity, sometimes you have to try a little harder, but we have the same high expectations," she says. "They are just as bright as any other kids."

There have been bumps along the road. In 2013, concerns about damage from blasting at a nearby road construction project caused officials to close the original high school building, forcing staff and students to move into Inez Middle School's campus and the middle schoolers to move to a separate campus.

"It was absolutely the worst-case scenario, because we went from a place where kids had a sense of community because they could go from place to place, and now we're in such a tiny space," says Hanson, who grew up in Martin County's Tomahawk community. "It would've been easy for them to have been defeated, for test scores to go down, for the teachers to stop teaching."

Williams credits teachers' efforts to build relationships with the students, as well as the high expectations set for them, for the school's ongoing success.

"I think of Maslow's hierarchy of needs – those physiological needs first, and then of course love and belonging, and then you can get them to the point … when they feel they're accepted, when they're cared for, that they want to work," Williams says. "You know, build those relationships with the kids, get to know them, and let them know, 'OK, this is what I expect.'"

Sheldon Clark senior Allison Horn has dreams of going to Thailand , India and some part of Africa – though she hasn't decided where yet. With brown, curly hair and eyes that shine behind a pair of glasses, she shares her excitement about a school club's recent summer service trip to Peru , and the news that she'd received a full-ride scholarship to Morehead State University , with plans to study chemistry once she gets there.

Horn says she considers herself "privileged" for not getting tied up in the county's drug scene, and fortunate for having had teachers that pushed her to be her best.

"All the teachers care, and if you're willing to work, they'll help you succeed," she says.

The new high school, a state-of-the-art building and campus that will also host the relocated Area Technology Center, is under construction off the road that led to its predecessor's closing. It is projected to be completed in the spring of 2019.

Students listen during a recent lesson in class at Sheldon Clark High School in Inez, Ky. (Brett Ziegler for USN&WR)

Water Woes

While education in Martin County appears to be improving, the county is struggling with a yearslong infrastructure crisis that residents say boils down to mismanagement of funds, poor leadership and old equipment in dire need of replacement.

"It's our own fault that we didn't fix it. … It's up to us how we spend that money, and we've made really stupid decisions," says Gary Ball, whose newspaper has helped document the long-running saga. "When the coal industry goes south like it's done, and you don't have the money, here you are left with crumbling infrastructure."

In October 2000, a coal slurry impoundment broke, spilling more than 300 million gallons of black, cement-like sludge and polluting area water supplies.

At the time, the spill was considered one of the worst-ever environmental disasters in the southeastern U.S. Today, residents living far from the municipal treatment plant in Inez complain their water still is not potable, and that it's affecting their health.

"Flint, they've had bad water, what, four years now?" says BarbiAnn Maynard, who lives in the Huntleyville community, about 25 miles from Inez. "October will make 18 years. We're going on two decades in the United States of America – that's an injustice."

In January, the county water district, deeply in debt, temporarily turned off water in an effort to conserve it; some residents went without water for days. In March, state authorities granted the district permission for a 10 percent surcharge and 17.5 percent rate increase – less than a nearly 50 percent hike originally proposed – but the district last month sought an additional increase of about 18 percent, which is still under consideration.

Since January, Maynard has traveled outside of the county each week to pick up bottled water donations sent from across the country, which she delivers to "low-income housing and the people furthest from another water source."

"I love where I'm from, I just hate how the people are being done," says Maynard, who's running as a Democrat for a county magistrate position in November. "That's why, if I leave, I still leave a whole lot of people that's still being done wrong."

The county's water woes have been blamed in part on elected officials who have used tax money from the mining of area coal on items like a business center in Inez, rather than shoring up the water system's pipes, lines and meters. Now, as coal has declined, so have those revenues.

Wealthy local businessman Jim Booth says he worked with others in the 1970s to expand the municipal water system from Inez to Warfield, but admits it's in need of an upgrade. He says he's never had problems with his water in Inez, but that the system has struggled to serve the area outside the main town.

"Every decision that related to the utilities has probably not been the best, but we've done OK," Booth says. "Our biggest problem now is we need more money put into the system in order to upgrade it. Our lines are old, and ... over time, we probably didn't manage it properly to keep the system in tip-top shape."

More than $13 million is thought to be needed for a complete system repair. In February, Kentucky Gov. Matt Bevin and Republican U.S. Rep. Hal Rogers announced $3.4 million in grant funding would go toward improving the area's water issues, coupled with $1.2 million in funding from economic development agency the Appalachian Regional Commission.

In June, Kentucky Attorney General Andy Beshear also announced his office would be "opening an inquiry into the past and present management and operations of the Martin County Water District." A spokesman for Beshear's office says the probe is continuing, with records being compiled and detectives conducting interviews earlier this month.

"Until we get good water in here, we're not going to get businesses in here, we're not going to get growth," Maynard says. "If I tell you, 'You can come in here and put this business in and I'll give you these great incentives, but you can't use the water' – what factory is going to?"

The water level sits low at the Curtis Crum Reservoir in Martin County, Ky. The reservoir is tied to the county's water supply, which has suffered from quality and infrastructure issues. (Brett Ziegler for USN&WR)

A Post-Coal Future

Down the main street of Inez, multiple shops are boarded up; three others struggle to survive. There's a gym at a local community center, a movie theater and a Dream Discovery Center for kids, but not much more to offer young adults, families or teenagers.

"We need jobs and we need things for people to be able to do," Maynard says. "All the counties around us are growing, they're doing things."

From 2010 to 2017, Martin County's population has declined an estimated 11 percent, according to census figures . As of July, its unemployment rate stood at 6.7 percent – down from 12.5 percent in January 2016 but above the national rate of 3.9 percent, according to Bureau of Labor Statistics data . Between 2011 and 2015, full-time coal mine employment in Martin County fell by 63 percent .

Among his business ventures, Booth runs Booth Energy , a coal-producing company with operations in Kentucky, West Virginia and Virginia . Near his local Matrix Energy operation, currently idle due to costs outweighing market sales prices for coal, is an industrial park on reclaimed strip-mine land. Booth says the site would be perfect for a manufacturing operation, such as the factory a California battery company announced last December it would build in Pike County .

The Martin County Economic Development Authority and Big Sandy Regional Industrial Development Authority – Booth serves as chairman of both – are trying to recruit employers to Martin County. Among them is an aerospace company from California that Booth says initially would offer 200 jobs and drive further employment opportunities, potentially leading to more people moving into the area and boosting residents' confidence and pride in their community.

"The more diverse employment that we've got for this area I think is the most positive thing that we can do," Booth says. "I think that would breed more of people starting to have more pride and self-respect."

While Hanson, the longtime high school teacher, says she's seeing former students return and reinvest in their hometown, other students are less certain their future lies in Martin County.

"It's my home, but there's not a lot of opportunities, there's not really any chances for jobs. And it's got a lot of drugs because once people lost their jobs when the coal industry went away, they just turned to drugs because that's all they really had left," says Horn, the high school senior.

Horn says her family has lived in Martin County for generations, but like a lot of her friends, she doesn't intend to settle back in her hometown immediately after college. "A lot of teachers encourage me to come back and help Martin County, but I don't think it'd be for a while," she says.

A'leigha Slone – Maynard's daughter and a senior who lives in Martin County but goes to high school in Pike County – says the same, pointing to "drugs and football" as the only recreational activities offered in the area.

"If you can get out of here, you want out of here," she says. "I don't want to live in a place that I know no one wants to change."

Maynard is more optimistic.