In the case of at least some of the guys I grew up with, it may be better understood as inequality of opportunity? Or of making choices that seemed OK, only to discover later that they were dead-end? Coupled with an inability to change gears, re-train, go down a different path?
For those who really were only suited to stand in front of a machine for eight hours a day (I knew a really nice guy who needed my help to fill out his IRS 1040-EZ), it's a real shame that the blue-collar manufacturing jobs that could once sustain some kind of life are just gone (to Asia, predominantly). For those with more potential...well, it's hard to break out of the habits, hard to start over, maybe have to relocate, etc. Has to be done, but hard; some can't do it.
I liked living in Snyder County. But I knew, from the time I was, I don't know, 14 or so?, that there was no future for me there. Fortunately, I grew up in a family that encouraged effort, that encouraged "going for it."