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“They’re tired of living in a third-world country…”

That is how the residents of McDowell County, West Virginia described their current situation: like “living in a third-world country.” Once you see this — water as dark as coffee coming from their faucets, a 45-minute drive to get a gallon of milk, little to no healthcare options, you’ll wonder if this is really 2026 in America. The 13-minute segment, shown above, was reported by CBS 60 Minutes and first aired on February 22 of this year.

There are persistent pockets of poverty throughout the United States, located mostly in southern and southwestern states and specifically in several counties within these states, a smattering of other areas where once booming industries have simply gone away for one reason or another, and most Indian reservations.

309 Counties Had Sustained High Poverty for Two Decades

According to a U.S. Census Bureau report published earlier this year, based on data through 2024:

In 309 or almost 10% of U.S. counties, mostly in the South, poverty rates stayed at 20% or more for two decades, according to the recently released American Community Survey (ACS) 5-year estimates.

The latest ACS release allows us to compare changes in poverty rates in most of the nation’s 3,144 counties and county equivalents in five-year periods over the span of 20 years: 2005-2009; 2010-2014; 2015-2019; and 2020-2024.

In this analysis, counties are considered in sustained poverty if their poverty rates remained at 20% or higher in each of the four nonoverlapping 5-year periods. [Emphasis Added]

This map produced by the U.S. Census Bureau shows the counties in “sustained poverty” over a twenty year period. McDowell County West Virginia is the southern most county in the state and is at the tip of a good-sized pocket of counties extending from southern Ohio into Kentucky and Tennessee.

McDowell county was one of our country’s largest coal producers, but the demand for coal decreased as the need for clean energy increased, and the coal companies abandoned the mines, the area and the people. Coal companies also abandoned the clean-up of mine waste, along with the old, failing infrastructure carrying water into residents’ homes that the companies initially installed. Now, the cash-strapped county is responsible for replacing the pipes and cleaning up the environmental contamination from the mines. And neither the West Virginia state legislature nor Congress wants to allocate money or hold the companies accountable to clean up the mess. By the way, McDowell County is considered the poorest county in West Virginia with over 37% of its population living below the poverty line.

What is it about these particular areas of the country, drilling down to specific counties, that keep them consistently poor? And if we know this abject poverty has persisted in the same areas for decades, why haven’t elected officials acted to help? Here is how the West Virginia Water Research Institute, part of West Virginia University, is trying to help

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