American writers have ‘discovered’ Appalachia on numerous occasions, typically at crucial moments when modernising urbanites want a counterpoint to their model of progress. From the savage-like frontiersman of the eighteenth century to the twentieth- century ‘welfare cheat’, southern highlanders have required some sort of moral uplift, personal motivation or human capital development, depending upon the reigning theory of poverty at the time. Consequently, well-meaning reformers have intermittently sought to mould a new culture from what they saw as the pliable material of the Appalachian people. No effort so galvanised America's desire to transform the upcountry South as Lyndon B. Johnson's Great Society. Absorbing more than a century's worth of stereotypes about Appalachians, Johnson's War on Poverty hoped to redeem the United States by healing one of its most persistent sores. Reformers and policy makers ultimately failed, according to Ronald Eller, not because of the inadequacies of mountain people, but rather because they treated Appalachians like clients, tried to apply urban programmes in rural areas, and refused to tackle the underlying problems of structural inequality.

Building on his now classic earlier work, Miners, Millhands, and Mountaineers (1982), Eller briefly recounts the region's industrial era as a period of colonial-like exploitation. Although the sweep is broad, the primary emphasis is on resource extraction, especially coal, in central Appalachia, which dispossessed landholders, triggered a mass exodus and left a pattern of economic growth resulting in ‘rich land - poor people’. After 1945, the boom and, predominantly, bust cycles of coal largely determined the welfare of the central core of the region, as the nation turned to oil and natural gas for its energy and industry turned to mechanisation, which meant that even the boom times benefited fewer and fewer Appalachians. By the time presidential hopeful John F. Kennedy campaigned in West Virginia in 1960, Appalachia was ripe for rediscovery.

Over the ensuing decades poverty warriors, armed with development theories, culture of poverty ideas, and service delivery models, descended on the region. From the outset, however, they faced entrenched local power structures, bureaucratic infighting, and rural citizens who resented being told what they needed. Meanwhile, programmes stressing development did little to equitably distribute benefits, either geographically or socially. Meanwhile, activists who spoke of empowering Appalachians to confront inequality faced hostile policy makers. Far too soon, partisan squabbling, war in Vietnam, and economic recession made the war on poverty a luxury that was too costly to continue.

Despite disappointments, Eller notes that gains were made, although often at the fringes of Appalachia. Poverty rates declined, per capita income increased and education and health care approached the national norms, but not in the coalfields at the region's central core. And probing questions about quality of life, the impact of development on the environment, and persistent inequality remained not just unanswered but not even asked. Eller has been deeply involved in these policy issues for the past thirty years; he has researched and written about this rural industrial region with passion, personal insight and a hope that is often lacking in work on Appalachia. Equally important, he insists that Appalachia is not a region apart, but rather that its dilemma is, in fact, increasingly America's dilemma.