WV and Appalachia in general have historically had poor communications (including cargo traffic as well as voice, etc). This resulted in a lower level of economic activity. In turn, the lower level of the local economy resulted in an out migration of youth.
But it is through communications and more especially personal communication from the youth that the attitudes of the older generation change. [Influence of children on parents].
WV is the only state to actually loose population over the last 50 years.
Is it really surprising that attitudes can be found there that have been [at least] greatly reduced elsewhere?
Attitudes are hard to change, and difficult to see in oneself, so the influence of family children is especially important. None of this is meant as a "put-down" to WV. The fix for this problem is not condemnation. It is finding ways to increase the economic viability of WV and the rest of Appalachia. If my thesis is correct, the attitude problem will then resolve itself over time.