For most of his life, Cody DeLong has been one of them.
"McDowell County is the hometown that you see in all those high school football movies," said DeLong, 22. "It's two-lane roads. ... We have one stoplight in the whole county. And the people are the greatest people you'll ever meet in your life."
A graduate of Concord University, DeLong said McDowell County was an excellent place to grow up.
But as he prepares to head to pharmacy school in the fall, he's not sure whether the home that shaped him -- and gave him his love for hunting and fishing -- will be a part of his future.
The state, and this region in particular, has been hit particularly hard -- from diminished demand for coal, long the economic bedrock of the region, to the opioid crisis gripping many rural towns.
Most problematic for McDowell County's future: People are leaving and not coming back.
The loss of coal mining jobs has accelerated in recent years. In the fourth quarter of 2011, coal employed 26,000 West Virginians. By the second quarter of 2016, that number had plummeted to just 12,000.
In 1950, McDowell County had nearly 100,000 residents, many of whom worked in the area's coal mines. Today, McDowell is one of the poorest counties in the country, with median household income under $25,000 and just over 20,000 people in the county.
West Virginia high school grads go to college at a lower rate than their American peers, with 55% enrollment, compared to 64% nationally.
With the future of southern West Virginia uncertain, we asked recent graduates from the region: Do they plan to stay in West Virginia to build a life and career, or do they feel the need to get out to succeed?
All the students we spoke with will enroll in college or have already graduated. Here's what six of them said about their futures -- and that of their home.
From the coalfields to Cambridge
Grace Bannister, 17
This fall, Logan County's Grace Bannister is heading to a place worlds away from where she grew up: Harvard University.
"I think there's a very large gap in the quality of life between where I'm from and where I'm going," she said.
Bannister has lost family members to drug overdoses and seen her father's mining supply company weather tough times to stay in business. She's concerned about the future of her home.
"I almost feel like it'll become like a ghost town because most of the population at this point is older," she said.
At Harvard, Bannister plans to major in government or anthropology. Unlike some other recent graduates we spoke to, Bannister wants to be a part of the change she says her home needs.