The Missourah counties south of I-44 disagree with the Lake of the Ozark's assessment. I lived down in those hills for a few years. The neighboring city fought getting 9-1-1 implemented as well as official street signs because they thought it was an invasion of Privacy. The Klan was still alive and well and even adopted a little stretch of state highway to keep clean. It was not uncommon for first cousins to be dating each other in high school or getting married due to the inevitable knock-up and drop outs of freshman/sophomores... The first two days of deer season were so important that the county school districts shut down (which is badass but still). Point is, while Appalachia may have Missouri beat it terms of backwoods, it's still a close call.