To add to the above, it was the altruistic folks of the 1960s and the Great Society federal welfare state that institutionalized this self-destruction. In Appalachia, poverty and self-sufficiency went hand in hand and the dole was shameful as EGM noted above.

However an army of earnest young Peace Corp types invaded Appalachia, seeking out the poor and convincing them it was a government program they were entitled to to relieve their material want.

So, the incentives to self-sufficiency or moving away to where the jobs were from where they weren't ended, and sloth and indolence and their subpathologies became a lifestyle...