I'm in Eastern Kentucky near Pikeville.
I been to Pikeville countless times in past 15 years. I think it is an oasis in the middle of the coalfields with the infrastructure that it contains. I like the job of the Cut-Thru. It looks like the center of a metro area and even has an arena. There are thousands of people passing by that city from hundreds of miles away going to Ohio to TN, etc. it is the cleanest looking city I ever seen in coal country. Very busy without an interstate highway. 460 goes thru there, takes you East to Bluefield and Princeton, 119 to Charleston and 23 to Columbus and Asheville.
I remember visiting Pikeville when I was a kid and looked much different and cut- thru was reason why, I believe the train and river went thru town and the city was like Welch, a bit dirty because of coal. Did not return until my 30s.
Now Hazard, Ky looks like Welch on steroids with similar built streets with separate one way main streets and a bypass on top of the mountain and a flooding history...