Over and over you ask the young adults why they don't move out to places where there's work. They tell you that some do, but the ones who stay do so because it's all they know and they're more comfortable with what they know even if it's poverty.
If you could start from scratch and design the United States all over again for a 21st century world, most of Appalachia would never be settled. It would be mostly national parks and resort towns.
In colonial times there was very little appeal to this region except for harvesting timber. It was difficult to farm there, and the Appalachian Mountains were seen as a barrier that had to be crossed to get from the port cities on the Atlantic Ocean to the prized fertile lands of the Ohio River valley. Once the area defined by the current contiguous 48 states had been settled, it was only the coal mining in the Industrial Age that kept Appalachia on the map.
“Over and over you ask the young adults why they don’t move out to places where there’s work. They tell you that some do, but the ones who stay do so because it’s all they know and they’re more comfortable with what they know even if it’s poverty.”
When I was in Navy recruiting school we had a class about, basically, not judging others on your standards. The instructor had been a recruiter in Appalachia. He met with a kid at a ramshackle shack with a crap strewn all over the yard. He told the kid, “I can get you away from all this”. The kid said, “Why would I want to leave? One day this will all be mine”.