The complete failure of the American corporate structure to accept even a charitable responsibility for the region that it has raped so successfully is hardly arguable.  Since men like General Imboden in the late nineteenth century went before the state legislatures to argue that "...within the imperial domain of Virginia, lie, almost unknown to the outside world and not fully appreciated by their owners, vaster fields of coal and iron than in all England, maybe, than all Europe,"  the  American corporate community has wrenched resources estimated at a worth of nearly one trillion dollars from the mountains.  While these companies pay some of the highest dividends of any company in the world to their already wealthy shareholders, the communities in Appalachia where those resources originated survive on a subsistence economy,  if "survive" is the proper verb here.  Often more than half of the money in circulation comes from state and federal welfare coffers.  This fact alone tells us something about the American Way, if not the American Dream.  Three months after the June 30, 1970 deadline for reducing the amount of hazardous dust in the mines as required by the 1969 legislation, 2800 of the 3000 underground mine operators had not complied.  It is these same companies which have continually opposed severance taxes on coal and medical benefits for the more than 100,000 disabled miners who suffer permanent lung damage from poorly maintained mines.  Apparently when these corporate institutions of American free enterprise become incredibly wealthy, they cannot be expected to have conscience even to allow government to pay the tab for the damage they have caused.  Somewhere that "pursuit of selfish interest accruing benefits to all" went astray in Appalachia.

     It has always been asserted with pride that America takes great interest in its children.  "Dr. Spock" has been a best-seller for over a decade.  But this "child-dominated" society has interest only in certain children.  Of  the more than 925,000 poor children under six in  Appalachia, as estimated by the Office of Economic Opportunity, only about 100,000 receive cash benefits in their home from Aid for Dependent Children or other similar welfare programs.  While the national participation rate of children in Head Start programs decreased three percent between 1967 and 1969, the Appalachia participation decreased fifteen percent.  The greatest decrease in Appalachia, significantly, was in full-year programs, those regarded as most beneficial to poor children.  What other group in the country received the benefits from the cutbacks in Appalachia is unimportant here; that "hillbillies" were not on the priority list is obvious.

     In the area of prenatal and infant care, the situation in Appalachia is even more alarming.  Examinations of children in several areas of the region have shown that as many as seventy percent have "parasitic infestation" (the euphemism for "worms"), one of the contributing causes of Appalachia's unusually large number of retarded and "slow" children -- "worms" abounding in the miserable shacks and grassless yards American free enterprise has put aside for the hillbillies.  If the Appalachian infant mortality rate were reduced at the same rate as East Germany's in a five-year period, as reported by the World Health Organization, then the lives of more than 1,000 children a year could be preserved.  In certain areas of the region, as a matter of fact, the situation worsened over a decade.  In Lamar County, Alabama, for example, the infant mortality rate rose from 32.5 percent to 40.9 percent in ten years.  Hancock County, Tennessee's rate rose from 21.4 percent to 42.2 percent in the same time period.  While increased attention to child development at the national and regional level promises to better the situation, for many lives and for many minds the help comes too late. 
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