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J.D. Vance’s bestseller Hillbilly Elegy offers an unflinching inside look at rural America. We can learn a lot about charitable work in rural areas from this book.

Opioid overdoses in rural areas have been on the rise for years—and now they are surging in the wake of COVID-19. Meanwhile, small hospitals teeter on the brink of bankruptcy, and farmers are dumping thousands of gallons of milk. Rural parts of the country, despite their low population density, have not escaped the destruction of COVID-19.

On Wednesday, July 29th, Senator Klobuchar from Minnesota spoke in front of the president and congress, urging them to set aside money for rural healthcare: “To me, the pandemic has just put a big magnifying glass on some of these disparities that already existed.” Small town America is making its way towards national consciousness, and everyone wants to help. As we consider how to best address rural poverty, a return to J.D. Vance’s 2016 Hillbilly Elegy clarifies what works—and what doesn’t. 

The New York Times bestseller Hillbilly Elegy provides readers with a shocking and candid look into the ancestry, culture, and lives of transplanted Appalachian families living in rural, rust-belt Midwestern towns. J. D. Vance tells the story of his tumultuous upbringing, complete with parental abandonment, drug addiction, alcoholism, and abuse. While he unblinkingly acknowledges the faults of his community, he also shows gratitude to the people and circumstances that led him out of poverty and eventually helped him graduate from Yale Law school. Vance’s insights share what statistics cannot: an indispensable understanding of how real people can flourish. Here are three lessons we can learn from Vance’s story about how we can actually help the rural poor.

1. Stick Around

Vance attributes a large part of his success to his grandmother, “Mamaw.” He and his sister would live with Mamaw when their own home became too violent, and throughout his life, Vance always knew she was rooting for him. Mamaw may not seem like an ideal role model for a young boy: she swore like a sailor and taught Vance how to punch bullies—once she even made good on a promise to pour gasoline on her husband and light him on fire if he came home drunk again, which he did.

Nevertheless, Mamaw gave to Vance and his sister an unwavering love and constancy. While other adults came and went, Mamaw was the one stable force in Vance’s life. “Mamaw was my keeper, my protector, and if need be, my own … terminator. No matter what life threw at me, I’d be okay because she was there to protect me,” Vance writes. She loved him fiercely, as only one who has loved for a long time can. 

Authentic transformation takes years, and for many suffering in impoverished rural communities instability is the only constant they have known. The help they need is not the vapid quip that “You have value” and “You are loved.” They need, instead, the long-term, committed relationships from abiding mentors like Mamaw. They need the stability that comes with patient love and care. 

2. Tackle “Learned Helplessness”

Conservatives are often attacked for expecting the poor to “pull themselves up by their bootstraps.” Vance, a professed Republican, adds some nuance to the point: perhaps the poor can’t see their own bootstraps. This culture of helplessness does not come out of a vacuum. Many of these people grew up in homes where, as children, they were literally helpless to change their parents’ poverty, abuse, or addiction. “Psychologists call it ‘learned helplessness,’” Vance writes, “when a person believes, as I did during my youth, that the choices I made had no effect on the outcomes in my life. From Middletown’s world of small expectations to the constant chaos of our home, my life had taught me that I had no control.”

Rather than confirming a sense of helplessness by removing agency from the poor or denying the real damage to self-understanding caused by a painful childhood, charities should work to help individuals overcome this tendency. Public and private programs that focus solely on needs of the poor, rather than their assets, merely affirm this sense of powerlessness. Vance’s experience in the Marine Corps taught him that now, as an adult, he isn’t helpless. His decisions really do have an impact. Those who work with low-income individuals should encourage them to take on challenges—getting a job, reconnecting with estranged children, getting off of public assistance—and then be right there for support. The only way to combat learned helplessness is to rewrite the narrative: individuals are empowered when they experience personal victories. 

Charities would do well to help those in impoverished communities realize the small personal victories that help them understand their own agency. That means first acknowledging that their agency has been hindered, but not eliminated, by their upbringing. Understanding this is key to helping these communities.

3. Reject Materialism

Vance and his neighbors grew up with lavish Christmases, despite their utter poverty. His family would “somehow manage to spend just more than we had on holiday shopping,” whether through payday loans, writing a future date on checks, or simply asking the grandparents for some cash. While these families had so little, they valued material goods to an unhealthy degree. As an adult, Vance was astonished to find that with stable families, “there was no obsession with meeting a two- or three-hundred-dollar threshold for each child, no worry that a kid would suffer in the absence of a new electronic gadget.” Parents didn’t measure their love in the number of gifts under the tree, and their children didn’t either. 

When aid organizations see poverty as merely a material problem, they come up with merely material solutions. Brokenness, though, lies much deeper than finances—and this is what Vance’s mother failed to recognize. Her extravagant Christmas gifts didn’t make up for a lack of stability in the home. When material needs are the only ones acknowledged—whether that’s giving away Christmas toys or welfare cash assistance—we send the message that poor individuals are nothing more than a mouth to feed or an empty bank account.

Of course, we know that money is not the whole solution when we have struggles in our own families. The solution is counseling, a job, a healthy marriage, a vibrant community. Dropping off bags of toys to combat poverty can exacerbate rather than mitigate the problem, suggesting that material abundance is the solution to a happy life. Charities must see the suffering poor differently—they must see the whole person, with more than merely material needs, in order to help those in need see themselves differently. The goal must need be medicating material need, but facilitating a deeper healing that will make a lasting change. 


Be present, encourage personal growth, and look deeper than material needs. All these principles have one thing in common: they are complex. But aren’t human beings just that? As government officials and nonprofit leaders look to help the rural poor, working through small, local organizations, rather than impersonal bureaucracies, is key. True healing in these communities is only possible through long-term relationships that allow for each complex man or woman to be deeply known, believed in, and loved.

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