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Nearly 2,300 miles of roads through Appalachia have been completed at a cost of $6.2 billion, and federal grants have given more than 800,000 families access to clean water and sanitation facilities.

But while many parts of this 13-state region that stretches from New York to Mississippi have reached parity with the nation as a whole, rural central Appalachia, which includes Eastern Kentucky, remains very much a region apart.

The Appalachian Regional Commission, the agency dedicated to lifting Appalachia out of poverty, considers 91 of Appalachia's 410 counties economically "distressed." Thirty-five of those counties are in Eastern Kentucky.

Despite the commission's efforts, the poverty rate in Appalachia's most remote, rugged stretches remains about double the nation's. Per capita and family income in these areas are only about two-thirds of the U.S. average.

As metropolitan areas spread to include much of official Appalachia, and resources are directed at regional growth centers, the areas of entrenched poverty face an "outlook that is still fairly grim," says Ohio University sociologist Ann Tickamyer.

"I think what we'll see in the near future is more of the same -- sort of nibbling away at the edges," says Tickamyer, co-author of a soon-to-be-released study of the region's depressed areas. "And the persistence of severe poverty, the most severe poverty, in the most remote areas."

After almost $10 billion in federal spending in four decades, only eight of the 410 counties in Appalachia are equal to or better than the national average on indicators such as per-capita income, poverty and unemployment rates. But the number of counties in the region that are considered "distressed" has been reduced from 223 to 91 since 1965. Those are counties with poverty and unemployment rates that are at least one-and-a-half times the national average.

Separate but linked

The Appalachian Regional Commission was formed under President Lyndon Johnson at the urging of Appalachian governors in 1965, a year after the start of the War on Poverty. The two crusades were separate but linked in their bid to eradicate poverty. While the War on Poverty became a national program, the ARC's focus has been exclusively on Appalachia.

The governors of each of the 13 Appalachian states help set the commission's policy and decide which projects to fund -- a structure that some observers say is both a strength and a weakness..

Development and highways

In recent years, the commission's policy has been to spend 50 percent of the agency's money for economic development projects on distressed counties and areas

In addition to funding economic development projects, the agency is building a new highway system throughout the region. The system is about 80 percent complete, and the agency spends about $450 million on it annually.

That's compared with about $66 million the agency spends yearly for economic development projects. ARC supporters say if the agency is falling short of its goals, a lack of money on the economic development side may be to blame.

During the early years, the agency often got about twice as much as it gets now for economic development. But getting more money anytime soon appears unlikely.

Congress rejected a bid to boost the agency's budget by about $10 million to fund technology investments a few years ago. And the Bush administration attempted to cut the 2004 budget in half to a little more than $30 million. Lawmakers from Appalachian states stopped that reduction, and the White House backed off when proposing next year's budget, but ARC supporters haven't been able to win new funding increases.