HAZARD, Ky. — When Democrat John Edwards brings his presidential campaign to eastern Kentucky Wednesday, he'll find an area that's much changed from 1968, when Sen. Robert F. Kennedy toured the region, stood on the steps of the Floyd County courthouse and vowed to fight poverty.
Gone are the tar-paper shacks that dotted hillsides - barely enough to ward off the cold of winter, even with coal stoves blazing inside. Outhouses are no longer the norm. And one-room schoolhouses are unheard of.
Today, four-lane highways cut through the mountains, connecting residents with regional hospitals, community colleges, chain restaurants and retailers such as Wal-Mart.
But poverty has not been whipped.
High school dropout rates are still higher than in the rest of the state; per-capita income is comparatively low; and many lack access to public water and sewer systems.
While there's no question that the region is better off than it was 40 years ago, large numbers of people in Appalachia are still suffering. So much so that Edwards has chosen to follow in Kennedy's footsteps, stopping in Letcher and Floyd counties as he completes his own tour of areas plagued by chronic poverty.
Edwards, who is spending three days visiting towns and cities in eight states - said he hopes the tour will focus attention not just on the problems, but also on the solutions to poverty. He has made ending poverty in America a pillar of his campaign and has laid out a plan to do so in 30 years.
He follows in the footsteps of many. Lyndon B. Johnson stopped in Martin County in 1964. Bill Clinton stopped in Jackson and Perry counties in 1999.
Some doubt Edwards' visit will change much.
"John Edwards coming to Whitesburg, I don't think it will amount to a hill of beans," said Paul E. Hall, director of the Kentucky River Area Development District. "I hope I'm wrong, but it didn't make a difference when everyone else came."
At 11 a.m. Wednesday, Edwards will hear from youths who are part of the Appalachian Media Institute at Appalshop in Whitesburg. He will make a brief speech at the Floyd County courthouse in Prestonsburg about 2 p.m.
As Edwards searches for input, residents and leaders throughout Kentucky offer different ideas about what would help pull this region up.
For Kim Jones, 26, the answer lies in more jobs with better benefits, including health insurance.
Jones' husband, Renza, has been out of work since injuring his knee and back in a car crash about five months ago. Doctors say he needs surgery.
But Renza, who has worked for six years as a cook at the Huddle House in Hazard, doesn't have health insurance. Neither does Jones, who is a nurse's aide.
They can't afford to pay for the surgery, and doctors have refused to set up a payment plan, Kim Jones said.
"We don't know what to do," she said. "We have nowhere to turn."
The couple and their 9-year-old son have been surviving on her weekly paycheck. After bills are paid, they have about $150 left for food, gas and other necessities each month, she said.
To make ends meet, the couple has turned to a business that many in the mountains rely on. They attend auctions - sometimes as many as five evenings a week - in Knott County, where they buy items and attempt to resell them later for a higher price.
Without the extra income, the Joneses say, they don't think they would make it.
"It's hard sometimes," she said. "And if you look around here, everybody has a story like mine. The jobs around here are low-paying compared to away from here and they don't offer good benefits - if they offer any at all."
Without good jobs to strive for, she said, most young people in the mountains leave. Many of those who stay lose hope and get wrapped up in a vicious cycle of drug use. They depend on welfare or other government programs to get by.
"It's sad," she said. "But it's the reality here. The way things are going, my boy doesn't have a chance."
Justin Maxson, president of the Mountain Association for Community Economic Development, says many of the businesses his organization works with struggle to provide health insurance to employees.
Maxson, who says workplace benefits can help build a middle class, encourages Edwards to look at such issues as he studies poverty.
Jerry Rickett, president and chief executive officer of Kentucky Highland Investment Corp., which focuses on economic development in 22 Appalachian counties, says more investment money is needed in Appalachia to help entrepreneurs start and build businesses.
Many of those would fail, but the owners that succeed would be more likely to stay and provide jobs in their home areas, Rickett said. Although many businesses would provide only a few jobs, "all big companies at one time are little."
John Rosenberg, a lawyer and formerly the director of Appalachian Research Defense Funds, says he is particularly troubled that eastern Kentucky relies so heavily on coal to fuel the economy.
"It's an industry that doesn't employ nearly as many jobs as it did," he said. "We clearly need a much better safety net."
Others say what the area needs most is better education - that many in eastern Kentucky lack fundamental job skills.
Former Gov. Paul Patton said poverty lingers because undereducated parents are not encouraging their children to go to school.
"We have undereducated parents who are poor, and they don't comprehend they are poor," Patton said. They encourage their children to follow in their footsteps, which continues the poverty cycle.
Hall, whose organization serves eight eastern Kentucky counties, agrees that much of the problem is handed down or self-induced.
"As long as we have a high school dropout rate as high as it is and a college graduating rate as low as it is, what can we expect?" he said.
Rick Baker is the assistant director of the LKLP Community Action Council, an agency formed in the 1960s that has operated a variety of programs to help disadvantaged people.
He said the situation has improved since the 1960s, but more work is needed. Anti-poverty programs put a safety net in place to meet basic needs such as food and medical care. The programs have lifted people from desperation, but the aid is not enough to move them to self-sufficiency.
"It's enough to provide for mere existence, and sometimes it doesn't even do that," Baker said.
It will take more assistance to make people self-sufficient, not in the form of a handout, but rather tailored to provide education and jobs, Baker said.
Baker said he would love for LKLP staffers to get a chance to talk to Edwards.
"I'm glad that he's bringing focus to it and I hope it's just a start," he said.
(Lexington Herald-Leader staff writer Bill Estep, news researcher Linda Niemi and computer assisted reporting coordinator Linda J. Johnson contributed to this report.)