Dee Davis, president of the Center for Rural Strategies in Whitesburg, Ky., said America should pay attention to the conditions in Appalachia.
"When the banking industry melts down, it's like, 'Oh, no, we have a structural problem. We need to reinvest in those people.' But when the folks in Appalachia or the inner city are poor, it's their fault," Davis said. "It's a lot easier to blame people for their poverty than to figure out what's next."
Only one in 10 men in the region will get a college degree -- less than half the national average. For those who do not, the only employment options are Wal-Mart, fast food, the drug trade or the mines.
Sixteen percent of America's coal comes from the hills of Appalachia.
Diane Sawyer traveled down into a mine to meet some of the men who work there. The mine, owned by Booth Energy, has a reputation for safety and caring about the men below. The miners work 9- to 12-hour shifts, six days a week, in return for one of the best wages and benefits in the region -- a starting salary of $60,000 a year.
Jeremy Hackworth, 18, loved math and wanted to be an engineer in the military, but when his girlfriend got pregnant, he said the responsible thing to do was provide for his family. Even though he's following his father and grandfather, it's quite a decision when a young man decides to go down into the mines for life .
When asked how he was liking his first day on the job, he said, "I love it."
"When these men go down under this ground, they don't know if they're going to come back out," said his mother, Lydia Hackworth, tearing up. "There's not a day don't go by that I don't pray for my boys under the ground, but I know God's going to bring them back."
When asked why they don't just leave the isolating hills, mountain people will tell you that once Appalachia is in your blood, it's in your blood forever.
"I love the voices," said Davis. "Every person, every challenge seems to be remembered in some story, in some way to make people feel better about who they are. I think, in many ways, Appalachia is America written with intensity.
"I mean, there's no reason to think that somebody who comes from the mountains of Appalachia can't succeed," he said. "I think it's just changing the contours of our expectations, and maybe the geography of our heart."