IN THE hills around Paintsville, a small town in eastern Kentucky’s Appalachian region, some of the nicer houses have paths that wind from the front porch up to a gate. Through these gates family cemeteries with headstones and brightly coloured imitation flowers can be glimpsed. These hallowed patches of ground help to explain one of the things that puzzles outsiders about Appalachia: why the people who live there remain so attached to a place that has been a byword for rural poverty for at least half a century.

Cynthia Duncan, a sociologist who recently returned to Appalachia to update “Worlds Apart”, an influential book on persistent poverty first published in 1999, says that though poor schooling and a fondness for a familiar landscape do tether people to the mountains, Appalachia’s poorest residents also have a remarkable capacity for resilience when faced with hardship, of which they have seen plenty. Mrs Duncan found that over the past 15 years some of the most troubled counties—in central Appalachia, which spreads across West Virginia and Kentucky, and in the southernmost part of the region, which stretches into northern Mississippi—have gone backwards, as new problems have piled on top of old ones.

Just as in poor urban America (see article), family structures in poor rural places have been upended. Appalachia once had lots of large two-parent families, where children dropped out of high school to help scratch a living, often in the informal economy. Now it has lots of small families with one parent or, in some cases, none at all. Where parents have become addicted to crystal meth, prescription painkillers or heroin, grandparents have stepped in and are taking a second pass at raising children. Mrs Duncan tells one story of a mother who sold her children to their grandparents, who subsequently sued their daughter in order to secure government benefits. This is not a typical tale, but it is the sort of anecdote that fuels hostility to welfare.

The 50th anniversaries of the War on Poverty, which fell last year, and of the Appalachian Regional Development Act, passed in 1965, have prompted a debate about why some places cannot shake poverty. Both sides have taken up familiar positions. Republicans claim that Lyndon Johnson’s other war has been a failure: that the well-meaning programmes it spawned have trapped people in poverty rather than liberating them. Democrats, meanwhile, have leapt to the defence of federal transfer payments, and continue to put their hopes for the poorest bits of rural America in government-led economic development. It is possible that both sides are wrong.

Since the mid-1960s the income gap between Appalachia and the rest of the country has closed (see upper maps), in large part thanks to transfers from the federal government in the form of food stamps, income-tax credits and Temporary Assistance for Needy Families. Spending on federal highways, which have a high cost per mile on account of the twisting, undulating terrain, have helped too. Without these initiatives there would probably be fewer people in central Appalachia, and those that remained would be even poorer.

Waiting for the next boom

This, then, looks like a victory for the Democrats. Yet the economic development that they hoped would follow government investment has not materialised. Perry County, which contains Hazard, has an employment rate of 42.5%; in Johnson County, which contains Paintsville, it is 41% (the national rate is 57.6%). In both Paintsville and Hazard the Mountain Association for Community Economic Development, an NGO, provides loans for new businesses. Yet the firms that appear liveliest are the storefront lawyers dealing in child support, car accidents and personal-injury cases. Roadside billboards advertise lawyers’ services to injured coalminers (“Working days over? Meet Grover”, reads one), who will take a cut of any payout.

Even as Appalachia has grown richer, it has become sicker. The combination of diabetes and the outflow of young people has led to a widening of the difference with the rest of the country in mortality rates, which measure the number of deaths as a share of the population (see lower maps). Male life expectancy at birth in Perry County is just 66.5 years, about the same as in Mongolia. Female life expectancy is better, but it has declined by two-and-a-half years since 1985.

Though the region has experienced many economic boomlets in the past—timber, salt, copper and gold all attracted opportunists before the coal boom of the beginning of the 20th century—Appalachia has been waiting for the next growth industry for a long time. The decline of coal jobs was well under way by the time the War on Poverty was launched. Mining enjoyed a mini-revival in the 1970s, during the oil shocks, but then resumed its downward trajectory. Natural gas and more abundant coal farther west have left Appalachia’s mines uncompetitive, a situation which locals are quick to blame on the Obama administration for waging a war on coal, with the Environmental Protection Agency as its infantry force.

Kentucky used some of the money it received from a settlement with tobacco companies in 1998 to encourage other businesses, from ostrich and llama farming to vineyards, says Ann Kingsolver of the University of Kentucky, but they did not take off. Hopes for the region’s economic future now revolve around tourism, call centres and selling environmental services such as carbon credits. Yet all these things require a more educated workforce, and at the moment people who study beyond high school tend to move away. For that reason, Mrs Duncan is not optimistic about Appalachia’s economic future.

The wrenching changes to mining and to families, combined with the absence of something better on the horizon, helps to explain something else that outsiders find baffling about Appalachia. Though the average voters of West Virginia and eastern Kentucky benefit greatly from federal transfers, they are increasingly hostile to the federal government. Since the introduction of the Affordable Care Act, better known as Obamacare, Kentucky has cut the proportion of people in the state with no medical coverage from 20.4% to 9.8%. Yet Obamacare is roundly denounced.

The statewide elections due this year are likely to see Republicans take control of the governor’s mansion on a government-shrinking platform. Democrats tend to interpret this realignment as a Republican plot to bamboozle poor voters out of acting in their best interests by pretending to be on their side. Mitch McConnell, the Senate majority leader and a senator from Kentucky for 30 years, seemed to perfect this art with a bumper sticker last year that simply read, “Coal. Guns. Freedom.”

But there is another way of interpreting the political shift, which is also under way on the other side of the hills in West Virginia, long a stronghold of white Democrats. Central Appalachia has borne painful changes for decades and yet there is still no end to them in sight. In these circumstances, it is not surprising that a party that is offering to make it all go away seems more appealing than one that can offer only more of the same.