The new hot topic is regional economic development, mostly because the victory of Donald Trump drew attention to lagging economic areas such as Appalachia and the Midwest.
The first noteworthy fact about this discussion is its recent flowering. No new information about these regions has come to light, except for the fact that they tilted the Electoral College toward Trump. That suggests we may be blurring two questions, with "How can we help these regions?" becoming a paternalistic "How can we get them to change their voting patterns?"
Mississippi and Louisiana, two of America's poorest states, haven't gotten a comparable outburst of new attention, perhaps because they reliably vote Republican in presidential elections.
The second noteworthy fact is that most of these lagging regions are not actually so poor, at least not in material terms.
Let's consider poverty indices, adjusted to account for government benefits to individuals. For Maryland, which is not generally considered troubled, and which usually votes Democratic in presidential elections, the measured poverty rate is 14.3 percent. For the relatively well-governed and reliably blue state of Massachusetts, the poverty rate is 15.1 percent. And what might the poverty rate be for West Virginia? 14.8 percent. For Michigan, the rate is 12 percent and for Ohio 12.2 percent.
The Appalachian and Rust Belt states definitely have economic problems, including a lack of advancing industries and highly productive firms. But in terms of poverty they do not stand out.
Arguably, the true malaise is largely cultural, resulting from a mix of mediocre outcomes relative to expectations, drug and alcohol abuse and dysfunctional white identity politics. To cite one striking fact, one West Virginia source reported, "In six years, drug wholesalers showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers." That works out to about 433 pain pills for every man, woman and child in West Virginia.
There are plenty of poorer regions in history, including the earlier West Virginia, without comparable levels of drug abuse.