In the next four years, the Trump administration and Congress will face many tests, but none will be more telling than what they do to help rescue West Virginia. Both Sen. Bernie Sanders and Trump made powerful appeals to the state’s unemployed miners.

Sanders, speaking at a rally in Huntington, pointed out that men in McDowell County have the lowest life expectancy in the nation at 64 years. He compared this with men in Fairfax County, Va., who have a life expectancy of 82 years. To address the region’s economic, health and social problems, he proposed a $42 billion federal investment to restore coal communities.

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Trump made coal the centerpiece of his West Virginia campaign. Placards pledging that “Trump Digs Coal” blanketed his rallies as he promised to repeal unfair trade agreements and “unleash an energy revolution that will bring vast new wealth to our country.”

The history of West Virginia is littered with countless oversold, failed promises by politicians of both parties. During the Great Depression, my grandmother raised 12 children in Eleanor, W.Va., one of three Subsistence Homesteads championed by first lady Eleanor Roosevelt. Kennedy, who credited West Virginia with giving him the Democratic nomination, used his first executive order to start a pilot food stamp program, and the first recipient was an out-of-work coal miner from Welch, W.Va. Lyndon B. Johnson created the Appalachian Regional Commission to jump-start economic development in the 13 Appalachian states. And Ronald Reagan made a forceful appeal to coal miners, saying: “We have an estimated one-half of all known coal reserves in the world. Why aren’t we mining more?” Despite these promises and many more, the state has never found economic equilibrium. The governor-elect, Jim Justice, ran a Trump-like campaign with a simple, provocative theme, “Tired of being 50th?” The answer for most West Virginians is “yes.”

West Virginia voters rallied to Sanders and Trump because they see no hope for themselves or their children — the poverty and hopelessness that shocked FDR and JFK are even more entrenched. The West Virginia economy, long tied to coal, has always endured a boom-and-bust cycle. The fear now is that the boom part won’t come again. The economic collapse has contributed to the rising tide of heroin and opioid addiction. To visit southern West Virginia today is to see what it looks like when every element of society starts to collapse.

West Virginia is the only state with a smaller population today than in 1950. McDowell and Logan counties, which are in the heart of the coal belt, had a combined population of more than 175,000 when JFK took office. Today, it’s under 53,000. Both Charleston, the state capital, and Huntington, the home of Marshall University, had populations of greater than 85,000 in 1960. Each has fallen below 50,000 today. Smaller cities run the risk of turning into ghost towns altogether.

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The United Mine Workers once enjoyed more than 800,000 members; now the state’s total coal mining workforce of 14,000 couldn’t fill a stadium. But it’s not just mining jobs that have disappeared. Ravenswood, a small town about an hour north of Charleston, was once a must-stop for political candidates who wanted to shake hands with the 4,000 steelworkers employed at the aluminum factory. That plant started to decline in the 1980s and has sat idle since 2009.

My home town of Nitro is in the center of what was once the state’s Chemical Valley. Monsanto, Union Carbide, DuPont, FMC and a number of other factories were the backbone of the local economy. My father, and almost every man I knew, worked in these factories. They enjoyed decent wages, comprehensive health benefits and pensions. Almost all of them were World War II veterans, Democrats and union members. They were grateful for the factories, excited by the new schools and roads in the town, and confident that Nitro was an important part of the nation’s economy. Today, Nitro is a shell of its former self. The factory jobs are long gone. A dog track and a Walmart are the major employers, and the once-prosperous central business area is dotted with the usual mix of antique shops and shuttered stores.

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In towns and communities across the state, families with a working vehicle and a few dollars have packed up and moved on. The elderly, the drug-addicted and the true believers hold on in desperate hope that a better future will emerge.

It’s undeniable that money is a major part of the equation. Congress appropriated around $100 billion to help address the consequences of Hurricanes Katrina and Sandy combined. Contrast that level of support with an announcement this past May by the White House, the Commerce Department and the Appalachian Regional Commission of $45 million in funding to help coal communities diversify their economies. Many of Trump’s West Virginia supporters may not have a college degree, but they understand the difference between $100 billion and $45 million. If West Virginia’s challenges were the result of a natural disaster rather than an economic disaster, the support would be exponentially greater. State residents are hoping that President-elect Trump will change this practice.

It will take more than federal funding to save West Virginia. The nation’s major charitable organizations need to take a second look at Appalachia. The work of the Gates Foundation in Africa is admirable, even heroic. But the economic, social and health challenges in places such as McDowell County deserve attention, too. The private sector needs to do more, as well. The pharmaceutical industry, which has been battered by 20 years of bad publicity, could make West Virginia a test site for restoring its reputation by helping with the drug crisis and sponsoring start-up enterprises. And nationally prominent academic institutions can partner with West Virginia University and challenge their students and faculty to help imagine a sustainable, post-coal economy.

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This isn’t an act of charity. West Virginia matters. To let one of our 50 states sink into economic oblivion is a threat to everything this country stands for. West Virginia has promise. There are pockets of prosperity and plenty of motivated, highly talented people willing to do their part to build a new future. But they need urgent, massive help.

To be fair, West Virginians must demonstrate that they’re prepared to help themselves, which starts by taking on damaging stereotypes: indifference to the environment, lack of interest in education and racial prejudice. As anyone who drives though the state knows, it’s stunningly beautiful but blighted with trash and abandoned cars, tires and appliances. It’s hard to persuade outsiders to care about the state if the residents don’t appear to care themselves.

The image of uneducated hillbillies hangs over West Virginia. There is no easy answer to this stereotype, but at the very least, the legislature should signal that it values education by putting an immediate stop to further budget reductions for the state’s public universities. Since 2008, West Virginia has cut funding for higher education by 42 percent, a decrease of more than $2,000 per student. With one of the nation’s lowest rates of college graduates, the state simply can’t afford to continue to defund higher education.

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And residents should speak out forcefully against the racist rhetoric of Pamela Taylor, the executive director of the Clay County Development Corporation, who posted a deeply offensive comment about Michelle Obama on Facebook. The announcement that she has been reinstated in her government-funded position is one more body blow to the state’s reputation.