The Demonization of Rural America

Downtown Paris, Kentucky on Sept. 7, 2016. Credit - Mike Belleme—The New York Times/Redux

By the time I was seven or eight years old, I was keenly aware of my father’s drug use. He didn’t snort pills in front of me yet—he saved that for my teen years—but he talked about pills freely and I knew he took them. He was meaner than usual when he couldn’t get his pills, and I learned to recognize the signs of withdrawal long before I ever heard that term. Any hope for stability in our lives probably vanished before I could walk. And by the time I became an adult, everyone in my nuclear family—and plenty of my extended family members—was struggling to cope with the impacts of violence, incarceration, and addiction.

I grew up in Appalachian Eastern Kentucky, where systemic poverty has been a challenge for many decades. We always joked that Kentucky was 20 years behind the rest of the country but as a kid, I didn’t understand what we really faced: underfunded schools, inadequate transportation systems, poor healthcare, unreliable utilities. Prescription pain pills flooded into our region and did nothing to cure our collective pain, but instead exacerbated the personal and social struggles that the region is often associated with.

Mason, West Virginia 2017<span class="copyright">Stacy Kranitz</span>
Mason, West Virginia 2017Stacy Kranitz

I was born in 1979, so most of this unraveling and destruction took place during the 1980s and 1990s. But it was sometime in the early 2000s when I read about the opioid epidemic online for the first time. At first, I was shocked to learn prescription pills had become a mainstream problem. But next, I was angry. By this time, pain pill manufacturers had changed their formulas so pills could no longer be crushed and snorted or injected; right away, heroin became widely available, which shocked me. When I was little, heroin was a city drug, scary and distant. Someone must have known that opiate-addicted hillbillies were a ripe market for a replacement opiate, just as someone had first found a way to saturate the Appalachian region with highly addictive pills without drawing attention to their crime.

But why wasn’t it talked about until now? Why wasn’t it an epidemic when it was ravaging my family for the last 20 years? Why wasn’t it newsworthy when my father chose pain pills over feeding his family, or when the same thing happened to families all around me?

I already knew the answer to those questions, though. Eastern Kentucky had been a throwaway place for a long time. Through a wide range of experiences, I learned at a young age that we were poor white trash. The stereotypes about us were, and continue to be, disdainful and dismissive, mixed with a potent disgust for good measure. Our accents are signs of ignorance and stupidity; we’re presumed to be shoeless and perpetually pregnant, sometimes—repulsively—even as a result of incest. Lawless and toothless, who would decry a manmade epidemic that wiped out thousands of hillbillies and their worthless children?

Read More: Kentucky Floods Destroyed Homes That Had Been Safe for Generations. Nobody’s Sure What to Do Next

Americans have discarded and scapegoated various socioeconomic groups throughout our history—this is not a new phenomenon. Unlike many biases that we have reckoned with, though, the vitriolic view of Appalachia—and to some extent, other areas of rural America—stems from an entrenched classism that remains unchallenged in our collective moral consciousness.

The most popular Mexican restaurant in our small town of Berea, Kentucky, has several machines where you can buy gumballs, small toys, and even temporary tattoos. When they were little, my kids always begged for a quarter or two so they could buy something after we ate there. But there was one novelty that made me cringe each time and I forbade my children from spending quarters on it: the hillbilly teeth, which are “the first line of fake teeth purposefully designed to look trashy, hillbilly-like, and downright gross.”

The teeth didn’t offend my sensibilities as a young mother; they publicized my shame. I grew up in a holler and the well my father dug for our house never functioned quite right. My parents often had to pump creek water into the well so we would have water pressure and I knew we weren’t supposed to drink it. But we still mixed it into Kool-Aid and coffee, cooked with it, and brushed our teeth with it. Most of the time, we drank milk or pop.

My brother and I both had visible black cavities on our baby teeth and I looked forward to the day they would fall out. But when my permanent teeth grew in, they were spaced too far apart on top and crowded against each other on the bottom; my gums bled at humiliating moments. Somehow, I always knew my teeth were a sign of the particular kind of poverty I came from.

Why didn’t my parents get us clean drinking water and ensure we had proper dental care? The first reason for these oversights was my father’s drug addiction; the second was his relentless abuse of my mother, my brother, and me. Visits to the dentist, fixing the well, braces for my permanent teeth—those concerns fade into the background for both the drug-addicted and traumatized minds.

Pine Mountain, Kentucky, 2016<span class="copyright">Stacy Kranitz</span>
Pine Mountain, Kentucky, 2016Stacy Kranitz

When I moved away from my hometown, I found a way to hide my accent at college and work, as so many Appalachians do. But I couldn’t hide my teeth or fix them until I was well into adulthood. The hillbilly teeth at the Mexican restaurant served as a cruel reminder that it’s socially acceptable to mock the socioeconomic class I was born into; our problems are a joke.

Another popular, insidious sentiment loomed large in the 2016 election, and I suspect it was infused into early conversations about our opioid problem: “They deserve what they get.”

The 2024 book, White Rural Rage, highlights the problematic conversations around Appalachia in interesting ways. Early in the book, the authors claim that rural America poses “a quadruple threat to democracy” and they begin their critique with Mingo County, West Virginia. The authors decry the fact that this county’s majority vote went to Trump in both 2016 and 2020, but fail to acknowledge an important fact in Appalachian voting and indeed, in voting among many vulnerable populations: less than half of the registered voters cast a ballot in either election.

Even though this book doesn’t claim to focus on Appalachia, Mary Jo Murphy at The Washington Post suggests early in her review of it that “Someone write a new elegy for the bilious hillbilly, because these authors went for his jugular.” She addresses rural Americans from that point after. “Hillbillies” are historically associated with Appalachia, but the poor, white inhabitants of this handful of states don’t represent rural America as a whole. They’re used as an easy target—a convenient stand-in for the diverse population that actually comprises rural America—because they’re considered to be poor, ignorant, white trash that no one will defend.

There will be no social backlash against overt and covert claims that rural Americans deserve everything they get. Poor whites remain a safe target for political commentary and cheap humor alike.

Classism is not just a problem when someone writes a book about it. And it’s not just a problem when people take to social media to blame election results on some of our most disenfranchised citizens. Classism distracts us from solving our collective problems because it keeps us from asking the right questions. Classism tells us to blame rural whites for our country’s ills—just like other populations have been blamed in the past—demonizing our neighbors instead of the dysfunctional systems and perhaps even individuals who hold incredible power over our political and financial wellbeing.

Whether they are poor or not, white or not, rural Americans grapple with the same issues as everyone else: poverty, violence, addiction, and social decay are obviously not unique to rural areas. But this population faces those problems with fewer resources than their urban and suburban neighbors. Just as there is no excuse for bigotry, we cannot justify blaming our country’s challenges on a disempowered socioeconomic group. Placing blame fuels divide. We need to do some collective soul-searching to understand our biases and find a way to move past them.

Finding solutions is the harder work and the right work. That work requires that everyone has a voice and a seat at the table—especially the people who have historically been excluded. If we can find the courage to set aside classist prejudice, we might discover that there are no throwaway places and more importantly, no throwaway people. Not even hillbillies like me.

Hazard, Kentucky, 2011<span class="copyright">Stacy Kranitz</span>
Hazard, Kentucky, 2011Stacy Kranitz

Photographer Stacy Kranitz has been documenting life in Appalachia for over 13 years to challenge stereotypes and provide an honest look at a complex region.

Contact us at