They have no skills, no family living elsewhere and have literally no place else to go. So they stay and watch their towns and lives rot away in drugs and alcoholism and Government handouts. I've driven through some of these areas and there is a permeating sorrow that oozes out of the people and towns in the area. Go to an inner city where you see kids on drugs being raised by single parents with no hope, no future, no jobs, buildings falling apart, communities rotting and nobody has the energy to fix the core problems. Now, imagine that same inner city but instead of black and Hispanic people you have hillbillies and beaten down white people. That is the extreme poverty of rural West Virginia and Kentucky, rural Arkansas and Central Ohio. Some of these families have lived in the hills of Appalachia for eight generations. There is a sunk cost in just up and leaving that they will never get back and a paralyzing fear of what the outside world is like. If I ever win the lottery I want to get groups of poor inner city people and poor rural Appalachians together and get them to compare their lives. Maybe that combined anger will force some changes to address these folks.I see. Any particular reason why these weird people gather where they do?