Mark Schmitt has an insightful column inspired by "bittergate" that includes the poignant observation that "The problem is none of us have answers that are adequate to the economic circumstances of the depressed Appalachian belt."
One thing that I think is worth saying about this is that it may be a lot harder to help the people who currently live in economically depressed communities than it is to help the communities themselves. Oftentimes the best way for a person to improve his or her economic condition is to move someplace else -- to somewhere where his or her skill set can provide greater rewards. But in the United States, political representation is done by geographical area, so the tendency is for the residents of a given depressed area's representatives to be represented by legislators who want to bring help to the place rather than to the people as such.
This pattern is useful to local political elites, who are thus able to turn their constituents' economic problems into a valuable patronage machine. And it does some good for the people in need. But it often amounts to giving people $20 to stay put, when $10 to facilitate their ability to pursue opportunities elsewhere would do more good. This was one of the things I liked about John Edwards' anti-poverty proposals which were focused, among other things, on helping to break up areas of entrenched poverty. And even beyond the very poor, it's often just not feasible for a broad range of people to leave homes they own in depressed areas in order to seek better opportunities elsewhere. It's hard for me to imagine a government program to turn an economically stagnating area into a growing one -- this just isn't the kind of thing government programs are very good at -- but finding ways to make it easier for people to seize the opportunities that exist around the country seems eminently practical.