This report analyzes recent demographic data to examine the factors explaining the graduation of distressed counties and the persistence of distress in Appalachia and other regions of the United States. Low levels of economic diversification are found to be a key determinant of persistent economic distress, as well as low educational attainment rates, low levels of employment in professional services, high population shares of minority groups, and greater distance from metropolitan areas. This report also examines ARC’s individual distress indicators of poverty, unemployment and per capita market income to assess how well they perform in measuring changes over time.