Isolated pockets in Central Appalachia have three times the national poverty rate, an epidemic of prescription drug abuse and the shortest life span in the nation. Toothlessness, cancer and chronic depression are rampant. For nearly two years, ABC News cameras followed four Appalachian children and their families and neighbors, each facing unimaginable obstacles.
ABC News' Diane Sawyer poses with 12-year-old Courtney, second from right, and three generations of mountain women. Courtney's grandmother, Dinah, far left, holds her sister Sable, 2. Also pictured are Courtney's mother, Angel, far right, and sisters Hannah, 7, and Mary, 11. In total, 11 people live under one roof.
Watch "A Hidden America: Children of the Mountains" tonight at 10 p.m. ET