Hillbilly No More

But while you and I can reinvent ourselves by revamping our Facebook page, West Virginia's overhaul may require a deeper, more delicate approach, not least because many of the state's stereotypes are both longstanding and rooted in at least some fact.

Born gloriously during the Civil War as an antislavery, pro-Union slice of Virginia, the state was tarred by colorful 19th-century travel writers who claimed that isolated West Virginians prayed to the hills and still spoke Elizabethan English. Eleanor Roosevelt's poverty tour through mining towns in the 1930s once again trained the national spotlight on Appalachia and flooded national newspapers with shots of barefoot kids, toothless adults and ramshackle huts. Ditto the Lyndon Johnson–led "War on Poverty," which took Robert F. Kennedy to Appalachia's depressed coal region.

Decades later, the state is still battling some of the core problems underlying those stereotypes. More than 40 percent of the state’s older adults are toothless—the highest rate in the nation, according to the CDC. Nearly a third of all adults have lost six or more teeth. And because the state's Medicaid and Medicare programs do not generally reimburse for dentures or routine care for adults, and rates of dental insurance are low, West Virginians often end up living without teeth or with painful decay that looks all too much like the plastic "hillbilly teeth" still sold for Halloween. Compounding both the image and health issues, the state has the nation's highest rate of chewing-tobacco use and is among the top three states for tobacco use in general. Meanwhile, Huntington has the less-than-stellar honor of being the nation's unhealthiest city—a place where 50 percent of adults are obese. And, while the high-school graduation rate (72 percent) is two points above the national average, close to a fifth of the state lives in poverty.

As for those perpetual rumors of high incest rates, many of the state's mountain communities—unconnected by paved roads and railways until after World War II—have indeed been isolated enough to raise eyebrows about genetic diversity. But it has been the court of public opinion, fueled by programs like ABC's report from the region, rather than serious researchers who have suggested that there's something unusual about the incidence of incest in West Virginia. In 2004 Abercrombie & Fitch sold a shirt emblazoned with a map of West Virginia and the words IT'S ALL RELATIVE, while just last year then–Vice President Dick Cheney cracked that he had Cheneys on both sides of his family, "and we don't even live in West Virginia."

All of which suggests that Manchin's PR efforts may not be enough, and may even backfire. He extracted an apology from Cheney, and has vowed a zero-tolerance policy on the ongoing pop-culture slander of his state. "Every time I see it, I attack it and I defend us," he tells NEWSWEEK. But countering stereotypes means running the risk of reminding people of them in the first place. "Programs intended to diminish prejudices probably just as often reinforce them," says Dave Schneider, a Rice University psychologist and author of "The Psychology of Stereotyping." For example, luring filmmakers with low tax rates and scenic mountains doesn't mean they'll represent the area positively once they get there. Last year the Julianne Moore film "Shelter" issued a casting call for deformed people to play West Virginian "inbreds." The casting director got into hot water over the incident, but it's an indication of how too many outsiders still view the state.

Even some of West Virginia's own residents are having trouble seeing themselves differently. A call for a suitable state spokesperson has yielded a mixed bag, including people who wrote in with references to "loving my hills" and a place "where time stands still"—hardly the progressive, go-getting image the state wants to project. Bill Lepp, five-time victor of the West Virginia Liars Competition, is also a nominee.

There's also a certain lack of cohesion between officials and locals when it comes to promoting the state's big makeover. While the governor is pushing a forward-thinking "New West Virginia" campaign, tourist-conscious businesses in some parts of the state are proudly serving up less refined fare. The annual Road Kill Cook-Off in Pocahontas, for instance, features dishes you're unlikely to see at your local restaurant, including intestine-challenging "flat cat," "bumper bruised bear" and "deer schmear fajitas." The mere mention of it puts a hard edge in the governor's voice. "Are they still running that s––– down south?" he asks an aide in disbelief, before adding: "Well, I tell you what, if you see [the organizer], kill the son of a bitch."