[pwg]

Another aspect unstated in the article is that in the parts of Appalachia being referenced in the article, and during the time frames given, often coal mining was one of very few jobs even available to the residents to begin with. When your majority work choices amount to: "coal miner", "logger", or "unemployed" one does not have a lot of options.

The Appalachian mountain coal mining areas are rough country, and until relatively recently (last 20 some years or so) there were not many job options available (beyond mining or other hard labor jobs) for the families that live in those areas. Even today in 2018, while better, the job opportunities pale in comparison to the opportunities in major metropolitan cities.

Source: Maternal grandparents are from VA portion of Appalachian mountain chain, grandfather was a coal miner, although luckily he did not succumb to black lung disease. Large extended family still lives there.