Richard Drake has skillfully woven together the various strands of the Appalachian experience into a sweeping whole. Touching upon folk traditions, health care, the environment, higher education, the role of blacks and women, and much more, Drake offers a compelling social history of a unique American region. The Appalachian region, extending from Alabama in the South up to the Allegheny highlands of Pennsylvania, has historically been characterized by its largely rural populations, rich natural resources that have fueled industry in other parts of the country, and the strong and wild, undeveloped land. The rugged geography of the region allowed Native American societies, especially the Cherokee, to flourish. Early white settlers tended to favor a self-sufficient approach to farming, contrary to the land grabbing and plantation building going on elsewhere in the South. The growth of a market economy and competition from other agricultural areas of the country sparked an economic decline of the region's rural population at least as early as 1830. The Civil War and the sometimes hostile legislation of Reconstruction made life even more difficult for rural Appalachians. Recent history of the region is marked by the corporate exploitation of resources. Regional oil, gas, and coal had attracted some industry even before the Civil War, but the postwar years saw an immense expansion of American industry, nearly all of which relied heavily on Appalachian fossil fuels, particularly coal. What was initially a boon to the region eventually brought financial disaster to many mountain people as unsafe working conditions and strip mining ravaged the land and its inhabitants. A History of Appalachia also examines pockets of urbanization in Appalachia. Chemical, textile, and other industries have encouraged the development of urban areas. At the same time, radio, television, and the internet provide residents direct links to cultures from all over the world. The author looks at the process of urbanization as it belies commonly held notions about the region's rural character.