How the War on Poverty became the War on the Poor: Central Appalachia as a case example

The progress and the regress.

By James L. Werth, Jr., PhD

President Lyndon B. Johnson reportedly declared the War on Poverty from Central Appalachia because he recognized both the hopelessness that had beset the region, where some counties had almost half of the residents below the poverty line, and the hope of what was possible if people were helped to overcome the crushing burden of economic hardship. Now, 50 years later, it is fair to ask what progress has been made in the War on Poverty and there is no better place from which to answer this question than from where it began, by examining the current state of affairs in Central Appalachia.

According to some accounts, the War on Poverty has failed — not because of a lack of financial commitment but rather because of the people who were supposed to be helped. One commentator opined that, “While the state of neediness we call poverty does involve a lack of material resources, it also involves a mass of psychological and moral problems, including weak motivation, lack of trust in others, ignorance, irresponsibility, self-destructiveness, short-sightedness, alcoholism, drug addiction, promiscuity and violence” (Payne, 1999, p. 7). In other words, the problem is with the people, not the systems.

Given opinions such as these, both I and the author of the companion piece in this issue believe that the APA’s Committee on Socioeconomic Status perspective that the War on Poverty has become the War on the Poor is apt. In this article and the accompanying piece, we explore the current status of poverty in Central Appalachia and look at some of the reasons why it has been so difficult to make progress. Not surprisingly, contrary to the previously quoted author, we believe that many of the issues lie with the systems in place that disempower and disenfranchise people who are poor. We offer some potential solutions to those who are willing to take on and battle the systems keeping people down.

Appalachia/Central Appalachia

According to the Appalachian Regional Commission (ARC), “The Appalachian region includes all of West Virginia and parts of Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia. The region is home to more than 25 million people and covers 420 counties and almost 205,000 square miles.” Given the diversity of this large an area, we focus on the central Appalachian region of southern West Virginia, southwestern Virginia, eastern Tennessee and eastern Kentucky, where coal still is king and a large percentage of people live in hollers and the surrounding mountains.

The ARC has a wealth of statistical information in a number of reports. I provide citations for summary documents below, which is where the data I list can be found; otherwise if quotes are from webpages, I provide the links in the text. Of direct relevance to our current topic, the ARC summarized that "In 1965, one in three Appalachians lived in poverty. Over the 2007-2011 period, the region's poverty rate was 16.1 percent. The number of Appalachian counties considered economically distressed was 223 in 1965; in fiscal year 2014 that number is 93.” A county is labeled as “distressed” if it ranks “in the worst 10 percent of the nation’s counties” on economic indicators (ARC, 2013). Notably, over half of these remaining 93 are in central Appalachia, especially eastern Kentucky, and it is likely that these are a subset of the original 223, which would make them examples of “persistent poverty counties.” However, “Despite progress, Appalachia still does not enjoy the same economic vitality as the rest of the nation. Central Appalachia in particular still battles economic distress, with concentrated areas of high poverty, unemployment, poor health and severe educational disparities. And recent economic data show that the region has fared far worse in the current recession than the rest of the nation."

Per capita income 2007-2011

The fact that nearly every county in central Appalachia reported poverty rates of 20 percent + for the period of 2007-2011 (compared to a national average of 14.3 percent) and that this region as a whole had a poverty rate of 23.5 percent reveals that many people are still struggling (Pollard & Jacobsen, 2013, Table 7.2 [p. 36] and Figure 7.6 [p. 42]). The high rates of poverty are correlated with other issues, such as educational attainment (over 27 percent of central Appalachians at least 25 years of age had less than a high school diploma and just over 12 percent had a Bachelor’s degree or more education whereas across the U.S. an average of over 85 percent of people had a high school diploma or more and over 28 percent had a bachelor’s degree or more) and employment (only about 60 percent of people 25-64 are in the labor force compared with over 78 percent nationally) (Pollard & Jacobsen, Table 5.1 [p. 22] and Table 6.1 [p. 31], respectively).

Some would argue that this is because of shortcomings of the people themselves, and would point to money that has been sent to the region to help Appalachians (e.g., Payne, 1999). However, the ARC reported that “the region receives 31 percent less federal expenditures per capita than the national average” (ARC, 2011, p. 4). As a result, “Appalachia has been unable to take advantage of programs that could help mitigate long-standing problems due to a lack of human, financial, and technical resources, geographic isolation, disproportionate social and economic distress, low household incomes, and a declining tax base” (ARC, 2011, p. 4).

Implications of the data

Individuals certainly bear some responsibility for their conditions and station in life. However, there also is no doubt that large systems can oppress and suppress people at an individual and collective level. As Burriss discusses in the companion piece, residents of central Appalachia have been living in a mono-economic system that purposefully provides little incentive for people to aspire to anything other than what previous generations experienced. Unfortunately, it is likely that things are going to get worse before they get better in this region because the coal industry in Appalachia is experiencing a downturn as a result of competition with natural gas, decreased exporting, and decreased domestic need. Thus, without some significant interventions, both from the residents themselves and from those given the responsibility to assist the people, the economic indicators reviewed above are likely to become bleaker.

Psychologists who are concerned about social justice and the plight of people who are living in poverty must be proactive in using their education and resulting influence and power we have to respond to the needs of people who have been disempowered and disenfranchised for so long that they feel hopeless and resigned to their plight. Burriss and I have focused on Appalachia in these articles but there certainly are communities in other parts of the country who are in need of assistance and we urge all civic-minded psychologists and graduate students to become involved through community-based participatory research, grant-writing, public education and policy development.


Appalachian Regional Commission. (2011, Sept. 29) Economic overview of Appalachia – 2011. (PDF, 1.24MB) Washington, D.C.: Author. Available at

Appalachian Regional Commission. (2013, Mar.). County economic status in Appalachia, Fiscal Year 2014. Washington, D.C.: Author. Available at

Payne, J. L. (1999, Jan. 1). Why the war on poverty failed: Handouts provide the wrong incentives. The Freeman. Available at

Pollard, K., & Jacobsen, L. A. (2013, Feb.). The Appalachian region: A data overview from the 2007-2011 American Community Survey. Washington, D.C.: Appalachian Regional Commission. Available at (PDF, 6MB)

Author biography

James L. Werth, Jr., PhDJames L. Werth, Jr., PhD, ABPP, received his PhD in counseling psychology from Auburn University and his Master of Legal Studies from the University of Nebraska - Lincoln.  He was the American Psychological Association’s 1999-2000 HIV congressional policy fellow where he worked in the office of Sen. Ron Wyden (D-OR) on HIV, aging and end-of-life issues. Until recently, he served as the founding director of the Radford University PsyD program in counseling psychology. He now is the Behavioral Health and Wellness Services Director for Stone Mountain Health Services, a federally qualified heath center serving the Westernmost counties of Virginia; the organization’s service area includes the three poorest and least healthy counties in the Commonwealth. He is a licensed psychologist who, for many years, provided pro bono counseling services to people with chronic and terminal illnesses.

Werth is the new Editor of the Journal of Rural Mental Health, which is published by the APA. He is beginning his third year on the APA’s Committee on Disability Issues in Psychology after completing a three-year term on the Committee on Rural Health. Previously, he served on the APA’s Ad Hoc Committee on Legal Issues and on all of the APA’s end-of-life working groups. He is the Rural Health Coordinator for the Virginia Psychological Association and serves as chair of the VPA Ethics Committee. His scholarship focuses on ethical issues, rural practice, social justice and providing mental health services to people who are dying and their loved ones.