THERE ARE LOTS of diversions in the Big White Ghetto, the vast moribund matrix of Wonder Bread–hued Appalachian towns and villages stretching from northern Mississippi to southern New York, a slowly dissipating nebula of poverty and misery with its heart in eastern Kentucky, the last redoubt of the Scots-Irish working class that picked up where African slave labor left off, mining and cropping and sawing the raw materials for a modern American economy that would soon run out of profitable uses for the class of people who 500 years ago would have been known, without any derogation, as peasants. Thinking about the future here and its bleak prospects is not much fun at all, so instead you have the pills and the dope, the morning beers, the endless scratch-off lotto cards, healing meetings up on the hill, the federally funded ritual of trading cases of food-stamp Pepsi for packs of Kentucky's Best cigarettes and good old hard currency, tall piles of gas-station nachos, the occasional blast of meth, Narcotics Anonymous meetings, petty crime, the draw, the recreational making and surgical unmaking of teenaged mothers, and death: Life expectancies are short — the typical man here dies well over a decade earlier than does a man in Fairfax County, Va. — and they are getting shorter, women's life expectancy having declined by nearly 1.1 percent from 1987 to 2007.

If the people here weren't 98.5 percent white, we'd call it a reservation.

Driving through these hills, you aren't in the Appalachia of Elmore Leonard's Justified or squatting with Lyndon Johnson on Tom Fletcher's front porch in Martin County, a scene famously photographed by Walter Bennett of Time, the image that launched the so-called War on Poverty. The music isn't "Shady Grove," it's Kanye West. There is still coal mining — which, at $25 an hour or more, provides one of the more desirable occupations outside of government work — but the jobs are moving west, and Harlan County, like many coal-country communities, has lost nearly half of its population over the past 30 years.

There is here a strain of fervid and sometimes apocalyptic Christianity, and visions of the Rapture must have a certain appeal for people who already have been left behind. Like its black urban counterparts, the Big White Ghetto suffers from a whole trainload of social problems, but the most significant among them may be adverse selection: Those who have the required work skills, the academic ability, or the simple desperate native enterprising grit to do so get the hell out as fast as they can, and they have been doing that for decades. As they go, businesses disappear, institutions fall into decline, social networks erode, and there is little or nothing left over for those who remain.

There used to be two movie theaters here — a regular cinema and a drive-in. Both are long gone. The nearest Walmart is nearly an hour away. There's no bookstore, the nearest Barnes & Noble being 55 miles away and the main source of reading matter being the horrifying/hilarious crime blotter in the local weekly newspaper. Within living memory, this town had three grocery stores, a Western Auto and a Napa Auto Parts, a feed store, a lumber store, a clothing shop, a Chrysler dealership, a used-car dealership, a skating rink — even a discotheque, back in the 1970s. Today there is one grocery store, and the rest is as dead as disco. If you want a newsstand or a dinner at Applebee's, gas up the car. Amazon may help, but delivery can be tricky — the nearest UPS drop-box is 17 miles away, the nearest FedEx office 34 miles away.

(Spencer Platt/Getty Images)

IF YOU GO looking for the catastrophe that laid this area low, you'll discover a terrifying story: Nothing happened. It's not like this was a company town in which the business around which life was organized went toes-up. Booneville and Owsley County were never economic powerhouses. They were sustained for a time in part by a nearby Midsouth plant, which manufactured consumer electronics such as steam irons and toaster ovens, as well as industrial supplies such as refrigerator parts. A former employee estimates that a majority of Owsley County households owed part of their income to Midsouth at one time or another, until a mishap in the sanding room put an end to that: "Those shavings are just like coal dust," he says. "It will go right up if it gets a spark." Operations were consolidated in a different facility, a familiar refrain here. But Owsley County was poor before, during, and after that period. Coal mining was for years a bulwark against utter economic ruination, but regulation, a lengthy permitting process, and other factors both economic and geological pushed what remains of the region's coal business away toward other communities.

"Well, you try paying that much for a case of pop," says the irritated proprietor of a nearby café, who is curt with whoever is on the other end of the telephone but greets customers with the perfect manners that small-town restaurateurs reliably develop. I don't think much of that overheard remark at the time, but it turns out that the local economy runs on black-market soda the way Baghdad ran on contraband crude during the days of sanctions.

It works like this: Once a month, the debit-card accounts of those receiving what we still call food stamps are credited with a few hundred dollars — about $500 for a family of four, on average — which are immediately converted into a unit of exchange, in this case cases of soda. On the day when accounts are credited, local establishments accepting EBT cardsare swamped with locals using their public benefits to buy cases and cases — reports put the number at 30 to 40 cases for some buyers — of soda. Those cases of soda then either go on to another retailer, who buys them at 50 cents on the dollar, in effect laundering those $500 in monthly benefits into $250 in cash — a considerably worse rate than your typical organized-crime money launderer offers — or else they go into the local black-market economy, where they can be used as currency in such ventures as the dealing of unauthorized prescription painkillers — by "pillbillies," as they are known at the sympathetic establishments in Florida that do so much business with Kentucky and West Virginia that the relevant interstate bus service is nicknamed the "OxyContin Express."

There's not much violent crime here. There's a bit of the usual enterprise one finds everywhere there are drugs and poor people, which is to say, everywhere. But even the crime here is pretty well predictable. The police chief's assistant notes that if they know the nature and location of a particular crime, they can more or less drive straight to the perpetrator.

There's a great deal of drug use, welfare fraud, and the like, but the overall crime rate throughout Appalachia is about two thirds the national average, and the rate of violent crime is half the national average. Booneville Police Chief Johnny Logsdon is justifiably skeptical of the area's reputation for drug-fueled crime. But he is not blinkered. "We have loggers and coal producers," he says. "We have educators and local businesses, and people in the arts. And we have the same problems they have in every community." He points out that the town recently opened up a $1 million public library — a substantial investment for a town in which the value of all residential property combined would not add up to the big lottery jackpot being advertised all over. He does not deny the severity or scope of the region's problems, but he does think that they are exaggerated by visitors who are here, after all, only because Owsley holds the national title for poorest county. Owsley's dependent underclass has many of the same problems as any other dependent underclass, but with a poverty rate persistently at the 40 percent mark, the underclass plays an outsized role in local life.

(Mario Tama/Getty Images)

THIS ISN'T THE Kentucky of Elmore Leonard's imagination, and there is nothing romantic about it. These are no fiercely independent remnants of the old America clinging to their homes and their traditional ways. This is the land of families of four clutching $40 worth of lotto scratchers and crushing the springs on their beaten-down Camry while getting dinner from a Phillips 66 station.

This is about "the draw."

"The draw," the monthly welfare checks that supplement dependents' earnings in the black-market Pepsi economy, is poison. It's a potent enough poison to catch the attention even of such people as those who write for The New York Times. Nicholas Kristof, visiting nearby Jackson, Ky., last year, was shocked by parents who were taking their children out of literacy classes because the possibility of improved academic performance would threaten $700-a-month Social Security disability benefits, which increasingly are paid out for nebulous afflictions such as loosely defined learning disorders. "This is painful for a liberal to admit," Kristof wrote, "but conservatives have a point when they suggest that America's safety net can sometimes entangle people in a soul-crushing dependency."

There is much here to confound conservatives, too. Jim DeMint likes to say that marriage is our best anti-poverty program, and he also has a point. But a 2004 study found that the majority of impoverished households in Appalachia were headed by married couples, not single mothers. Getting and staying married is not a surefire prophylactic against poverty. Neither are prophylactics. Kentucky has a higher teen-motherhood rate than the national average, but not radically so, and its young mothers are more likely to be married. Kentucky and West Virginia have abortion rates that are one fourth those of Rhode Island or Connecticut, and one fifth that of Florida. More marriage, less abortion: Not exactly the sort of thing out of which conservative indictments are made. But marriage is less economically valuable, at least to men, in Appalachia — like their counterparts elsewhere, married men here earn more than their unmarried counterparts, but the difference is smaller and declining.

Speaking in the Rose Garden in March 1965, Lyndon Johnson had high hopes for his Appalachia Bill. "This legislation marks the end of an era of partisan cynicism towards human want and misery. The dole is dead. The pork barrel is gone. Federal and state, liberal and conservative, Democrat and Republican, Americans of these times are concerned with the outcome of the next generation, not the next election... The bill that I will now sign will work no miracles overnight. Whether it works at all depends not upon the federal government alone but the states and the local governments as well." The dole, as it turns out, is deathless, and the pork barrel has merely been reincarnated as a case of Pepsi. President Johnson left out of his calculations the factor that is almost always overlooked by populists: the people.

This article is adapted from one that first appeared in the Dec. 16, 2013, issue of National Review. ©2013 by National Review, Inc. Reprinted by permission.