If Congress passes a reasonably ambitious spending package, I hope that some of the money can serve as at least a down-payment on the idea proposed last year by the mayors of Pittsburgh; Youngstown, Ohio; Dayton, Ohio; Columbus, Ohio; Cincinnati; Huntington, W.Va.; Morgantown, W.Va.; and Louisville. They call it a “Marshall Plan for Appalachia” and they cite Re-Imagine Appalachia‘s “New Deal” proposal for the region. They rightly recommend investing in the whole region, but they write as mayors, and I’d advocate for focusing substantial investments in the cities.

For more than a century, Appalachian resources, especially coal, were extracted to fuel US industrial growth. The social and environmental damage was grave, and now the region will bear a disproportionate price for de-carbonization. Already, about 15.2% of all residents of Appalachia live below the official poverty line. That’s not far from the 13.4% rate for the country as a whole, but poverty is concentrated in some Appalachian counties. McCreary County, KY has a poverty rate of 41% and a median household income below $20,000. Its last coal mine closed in 1994.

Appalachian residents live shorter lives than other Americans, and the gap is growing. According to Singh et al., “Cardiovascular diseases (especially heart disease), unintentional injuries (which include drug overdoses), and cancer accounted for 57.8 percent of the life-expectancy gap.”

Direct federal investments are appropriate and could help. However, the relationship between Appalachian residents and the federal government is bad, for deep and complex reasons. Trump won Leslie County, KY with 89% of the vote. (The county’s median household income is $18,546 and it ranks 3,120th out of 3,142 in life expectancy at birth.) I mention partisanship not to make a judgment about how people should vote, but for a pragmatic reason. I think it would be difficult to spend money effectively under conditions of deep distrust.

Appalachia is already more dependent on federal programs than any other region, but that has not made most voters favor those programs or their source. One resident, a Republican who previously voted for Democrats, told The New York Times’ Eduardo Porter: “People in Harlan County have been on the front lines of the war on poverty for 50-plus years and can see its actual effects. It is degrading.” Whether this person is right about welfare programs (as they are designed today) is immaterial; the point is that voters and local elected officials will not be primed to cooperate to make federal funding work. (Harlan gave 85% of the vote to Trump in 2020–having favored Democratic presidential candidates until and including 2000. Harlan ranks third from the bottom in the USA in life expectancy and has a median household income of $18,665.)

This is where the cities come in. Rural Appalachia is closely linked to nearby cities. In addition to Cincinnati, Columbus, Dayton, Pittsburgh, Louisville, Youngstown, and the West Virginia cities (whose mayors all signed the op-ed), one could add Allentown, Binghamton, Charlotte, Chattanooga, Lexington, Nashville, and Scranton, among others. People, goods and culture flow back and forth between these cities and rural areas.

And almost all of these cities have Democratic mayors. Again, I mention partisanship not as a value-judgment but for practical reasons. Municipal leaders who believe in government may work better with federal officials and may use federal funds better, particularly when that is what their voters demand. At the same time, thriving cities in or near Appalachia can create markets and other opportunities for rural residents.

Insofar as we can spend funds to boost rural Appalachia, I am all for it. Infrastructure spending may go over better there than welfare, for understandable reasons. But I am especially optimistic about the impact of federal funds for transportation, renewables, health, and education in the cities within or near the 420 counties of Appalachia.

See also A Civic Green New Deal; a Green recovery; who wants less government?; Building Civic Capacity in an Era of Democratic Crisis by Hollie Russon-Gilman and K. Sabeel Rahman