I'm from another poor, rural, conservative region in the US (which also happens to be very hilly).
The culture that's developed in regions with these characteristics (in the US) is averse to developing running talent:
1) Fat, inactive inhabitants.
2) Distance running is seen as effeminate -- not a real sport. They prefer football and the like, which often have a place for the many overweight (if not inactive) people.
3) Beyond a lack of popularity, the few runners that exist get heckled frequently (even if you refrain from wearing short shorts and tights). This frequently happened to me as a teenager and still does when I return home for visits.
In places like WV: You're ...
- Less likely to get into running to begin with;
- Less likely to receive support from your community as a young athlete; and
- Less likely to stick with your training in the off season.