Appalachian bleak house

Some Stories from Appalachia

by Abigail Conley

“They’ve got to come help those poor Appalachian people.” I remember the disdain in my mother’s voice as she said those words. I grew up in the foothills of the Appalachian Mountains. If you look at a poverty map of the United States, my county would be a lighter shade than those farther south or farther east, deeper into coal mining country. This was the place where coal was brought up on trains, then loaded onto barges to float down the Ohio River to Cincinnati.

As the trucking industry has replaced trains, the area has been bypassed. What were once company houses all along the river are now privately owned, though their outlines remain the same. Some Googling tells me that the population in that area was at its highest in the 1960s. My own thirty years of memory holds manufacturing and railroad jobs leaving, sometimes hundreds at a time, as recently as this year.

In high school, I participated in a leadership initiative funded by local businesses. “Leave,” they said. “Get an education. Then come back here. If our best people keep leaving, nothing here will ever change.” Looking back, I realize they had more vision than I gave them credit for. They saw we needed something. We’d do well to look at those somethings as progressive people, so here’s some perspective from someone who grew up in deep red, rural, white America.

Trust takes time. While Appalachia is a closed culture, this is generally true of rural areas. These aren’t places where someone can spend a few weeks or months, knock on doors, and get stuff done. People who have lived in a place for decades are still seen as outsiders. These are places where relationships reach back generations. There, I introduce myself by whose daughter I am. When I needed traveler’s checks in college, the fees were waived because the woman helping me knew my family. I couldn’t tell you who she was. It didn’t matter. There were generations of trust at play.

Drugs are one of the biggest threats. The stories I could tell you are horrifying. I remember an angry obituary a few years ago. One of the women in my high school class died in her mid-twenties. Her family took out their rage in the obituary, naming the “pill mill industry” and a few other things to blame. It’s true. Pharmacies pop up overnight, then disappear just as quickly. Oxycodone is nicknamed “hillbilly heroin” for a reason. These are places hurting from losing their children to drugs that they don’t understand. These are children turning to drugs because jobs are in short supply.

And yes, they need jobs. You’ve heard before that manufacturing jobs are drying up. That’s not just true in cities. The brickyards and railroads that used to be the good jobs are quickly disappearing in rural areas. My parents would love if I moved back there. I have no idea where I’d get a job if I did. Growing up, I never saw teachers as poor. These were coveted jobs because they meant good, steady paychecks and health insurance. Teaching would keep things afloat when the less steady but better paying jobs weren’t in season. A blue collar worker married to a teacher was common and worked out well financially. In the rest of the country, teaching is seen as underpaid and underappreciated.

Healthcare works differently.  Or at least most people wish it did. I went to the same doctor as my dad had gone to when he was a child. I think that doctor moved there when my dad was around eight years old. He was one of the people who wasn’t from there—and everyone remembered that—but had earned his place in the community. If you were sick, you just went to the office and they’d get you in. His prices were low enough that my parents didn’t even use their health insurance. In fact, later I learned that his prices were lower than an insurance copay. When he retired, the charge for an office visit was around $30. This was within the last ten years. I have no doubt he saw patients who couldn’t pay that much. I remember meeting him at his office in the night as a child, sick, before urgent care existed. At his office, he treated my sister for what was nearly blood poisoning, saving my parents a hospital stay he knew they couldn’t afford.

The first time I sat in another doctor’s office, I was overwhelmed. I’d never filled out paperwork nor seen my parents fill out more than a single sheet of paper. I’d never needed to find my insurance card. I’d never been somewhere that the office staff was unfamiliar. When we talk about health insurance and the Affordable Care Act, we’re already talking about systems that cause difficulties for these people. No one is inclined to sign up for more of it.

Guns really do matter. I don’t own a gun and doubt I ever will. That’s not true of anyone else in my family. Guns are for hunting. People care about how many points were in a buck’s antlers. Killing your first deer is a milestone. Some families rely on a freezer of meat for food. Also, in a place where police may not be able to get to your house within an hour or more, yes, guns are for protection, too. While there are some people who can’t imagine any gun control at all, there are easier conversations around guns for a large portion of this population. These are also the people who see guns as every bit as dangerous as they are, and treat them that way.

Paternalism never works. My mother’s offense that someone from outside would know better is real. We talk about that reality often with marginalized groups, worrying about being white saviors in black and brown communities. We talk about community empowerment, instead, and try to work with communities rather than dropping things we think they need. When we’re talking about white, rural and often poor people, we’re talking about people who are marginalized. They have to drive hours for services. They don’t have access to transportation. They live in old trailers instead of housing projects, but conditions are still bad. I fully acknowledge white privilege. The color of my skin means that no one assumes my childhood was spent living below the poverty line or questions whether I should be in certain rooms. That doesn’t change the reality that many of these people are struggling and existing systems don’t help them.

It’s easier to love some neighbors than others. I get that. Just this week, I officiated at the wedding of two lovely women. They’ve been together four years. They got married because they didn’t trust that next year they’d be able to. They got married because they were worried about one of them being deported. Most of us could tell dozens of stories of those neighbors who are more afraid now than they were a few weeks ago. Some of us could even tell stories of threats against those same neighbors. Still, Jesus says, “Love your neighbor as yourself.” As people of faith, we must work as hard to create relationships with the neighbors who offend us, and learn to love them, too. We must learn to see the brokenness they’re experiencing and help heal it, too. Those of us who are most privileged hold the most responsibility for this work; we are the people for whom this work is safe.

It is my deepest prayer that God will help us along the way.