Appalachia. Historically perhaps not the most well-known region in the United States, but one that has become the focus of attention since J.D. Vance published his autobiography Hillbilly Elegy in 2016, and that is once again in the spotlight with the release of Netflix film based on the book.
Stretching from the south of New York state to northern Mississippi, the 200,000 square miles of Appalachia covers 420 counties across 13 states. It is home to 25 million Americans, and synonymous with white working-class communities who swung to Donald Trump in the 2016 election, with many keeping their allegiance in the 2020 election despite Joe Biden taking Georgia and Pennsylvania. In his book, Vance – a former Marine and Yale Law School graduate – highlights a litany of failures in education, healthcare, the labor market and the justice system across the region. He describes in detail his upbringing in nearby Middletown, Ohio, and the dysfunctional family life built around the Appalachian values of his Kentucky-raised mother and grandparents.
The response to the film has generally been negative[i],[ii],[iii], but the book was a bestseller, although Vance was criticized by some at the time for pivoting from personal experience into broad generalizations[iv] and presenting an overly-simplistic and right-wing view of Appalachia[v]. But does Vance’s personal experience represent that of broader Appalachian society, and is his perception of the lack of hope and prosperity of the region fair?
The U.S. Prosperity Index reminds us that prosperity is multi-dimensional. It is about far more than a society’s economy or an individual’s financial wealth. Prosperity is an environment in which everybody is able to reach their full potential. A prosperous society has effective institutions, an open economy, and empowered people who are healthy, educated, and safe.
Based on a decade of data from before the coronavirus pandemic struck, the 2020 Index highlights the disparities in prosperity across Appalachia, which mirror the disparities seen across the country as a whole, although some of the weakest performing states are in this area. While New York state performs well, ranking 9th out of 51, five of the 13 Appalachian states are amongst the 10 weakest in the Index, including 51st-ranked Mississippi and 43rd-ranked Kentucky – where Vance’s grandparents originated.
Kentucky has seen an above average increase in its prosperity over the last decade, rising two places in the Index as a result, but the Index supports Vance’s assessment that there are still a number of weaknesses limiting the ability of citizens to reach their full potential. For instance, although governance has improved with greater government transparency and a more diverse legislature, corruption levels remain high. The state is generally safe and has seen a reduction in property and violent crime overall since 2010, but there has been an increase in murder rates and terror-related crime.
In addition, supporting Vance’s portrayal of unstable family structures, the Index reveals that Kentucky has some of the highest rates of divorce and teen births in the country, although they have fallen in the last 10 years. There has also been a decrease in the extent to which people talk and provide help to neighbors, volunteer in the community, and participate in clubs and societies. While this mirrors a general decline in neighborly interactions and community involvement across the US as a whole, Kentucky has experienced a greater decline. Stable families and supportive communities play a crucial role in instilling the values that shape the culture and build the bonds of trust needed for society to flourish, so reversing this trend is important for Kentucky to see prosperity grow more in future.
However, while Vance’s skepticism of the work ethic of Appalachian communities is partly supported by above average unemployment rates, the Index shows that Kentucky boasts one of the highest rates of business start-ups in the country and is also in the top five states for manufactured exports. The state has strong transport and communications infrastructure and over the past decade the availability of venture capital has increased, and the regulatory environment has improved with rates of tax reducing. Building on this open economy to harness ideas and talent will help Kentucky drive further growth in prosperity.
In addition to strong inclusive societies and an open economy, the Index also reminds us that prosperity is built by empowered people who have the material resources, health, and education they need to create a society that promotes wellbeing. This is where Kentuckians have the biggest challenges to overcome.
There are high and persistent levels of poverty across the state, with over a quarter of individuals on low incomes, almost one in six households reporting not having enough food for their family, and four in ten reporting a poor-quality diet. Not surprisingly, rates of obesity have been rising and one in three Kentuckians now classify as obese. Around 25% of the population smoke, compared to only 16% nationally, and rates of diabetes and high blood pressure are also high. Drug dependency, which Vance’s mother battled with for so many years, has been a particular challenge across Kentucky, with a 50% higher rate of drug overdose deaths than the national average. In addition, the increasing numbers of ‘deaths of despair’ – drug overdose deaths and suicides – have increased by 75% since 2010 across Kentucky and the U.S., leading to a deterioration in mental health, a trend that will only be further exacerbated by COVID-19.
Pushed by his grandmother to work hard at school, Vance was able to secure a place at Yale Law School. Kentucky ranks just 39th for education overall, but this hides a mixed performance across the education system. While it performs well for early K-12 (primary) education, this progressively deteriorates through the later stages of education, as relative to other states test scores at Grade 8 are poorer than they are at Grade 4. In addition, many students drop out of education after high school, leading to a state university enrolment rate of 38%, compared to 43% nationally, and there is a high drop-out rate with just 52% of students graduating. Consequently, adult Kentuckians are less educated, with only one in four holding a degree, compared to one in three for the U.S. as a whole.
Hillbilly Elegy provides a moving personal account of the lived experience of one man in a small area of rural America and the challenges he experienced. The Index is able to provide a broader and more comprehensive perspective of some of these and other challenges that residents in Appalachia, and other states, face but it also shows that there are strengths on which to build and examples from elsewhere from which to learn.
Using the Index to create targeted interventions, every region, state, and community – with Kentucky and other Appalachia states being no exception – can create an inclusive society, with a strong social contract that protects the fundamental liberties and security of every individual; an open economy that harnesses ideas and talent to create sustainable pathways out of poverty; and a society in which everyone has the opportunity to thrive by fulfilling their unique potential and playing their part in strengthening their communities and nations.