More than 50 years ago, in the spring of 1964, President Johnson roared into the small Kentucky town of Inez to declare a war on poverty. He met there a man named Tommy Fletcher, whose condition so struck Johnson that he recalled it many years later. Fletcher never graduated elementary school. He could barely read. The life he once knew, soot-slicked and inside the coal mines, was already long gone. “He regretted more than anything else that his two oldest children had already dropped out of school, and he was worried that the same fate would overtake the others,” Johnson wrote in his memoirs. “So was I.”

Johnson’s concern was warranted. For Fletcher, misfortune begat misfortune. The economy never improved. He never got back on his feet. Illness seized him. He broke a leg. Breast cancer took his first wife. And prison took the second one, who in 1992 was convicted of killing their 3-year-old daughter, the Lexington Herald-Leader found. He died in 2004, exhausted by talking about his life with reporters, embittered he hadn’t changed it.

The story of Tommy Fletcher is the story of many in Inez, which, despite its motto of “preserving the past — embracing the future,” has achieved neither. The coal mines throughout eastern Kentucky produce a fraction of what they once did, and the jobs that have come to replace them either paid little or never arrived at all. Inez anchors Martin County, which is one of dozens of counties swallowed by Kentucky’s 5th Congressional district, which statistics in a fresh report show is the unhealthiest place in the nation for the simple reason that people there live the shortest lives.

This information isn’t exactly new. Inez, along with the rest of eastern Kentucky, has long been mired in seemingly intractable poverty — hence the reason Johnson went there in the first place. But what makes the release of this new report by Measure of America so exciting is that it offers a new take on the same, old data that can help us to understand why things haven’t worked, while suggesting a solution for solving things: Immigration.

Economic stats, like the GDP, are lousy prognosticators of a community’s well-being, Co-Director Kristen Lewis said in an interview. So to bore deeper into what makes some communities succeed — and others fail — the institute applied something called the Human Development Index, which ranks each district on a 10-point scale. The tool, normally used by the United Nations in international comparisons, marshals an eclectic collection of data, from median incomes to employment rates to learning opportunities, to determine a community’s overall well-being.

The institute then used this tool on every congressional district to determine, more or less, which district’s have highest levels of overall well-being. “We wanted to shift how Americans measure progress away from measuring economic progress to how humans are really doing,” Lewis said. “And we do this with the human index. Money metrics don’t tell us everything we need to know about the people. … This was a way to show how different groups and populations are stacking up.”

At the very bottom of the list is Kentucky’s Congressional District 5, which sprawls across the hills of Appalachia. The numbers: In addition to an average life expectancy of under 73 years, more than one-fourth of its inhabitants never completed high school. Only 13 percent have at least a bachelors degree. More than 26 percent of residents have some disability, more than double the national average. And the median income is less than $25,000. It’s human index score was a harrowing 3.1.

Then there’s the very top of the list, California District 18, just outside San Jose. The differences in terms of well-being between this district and Kentucky’s District 5 are profound. The life expectancy is nearly 84 years, meaning that a person here can expect to live longer than residents of Japan, the world’s longest-living country. Sixty percent of inhabitants have at least a bachelors. Thirty percent have at least an advanced degree. The median income is more than $55,000. It’s human index score was 8.1 — more than twice Kentucky’s District 5.

“This means that a child born today in Congressional District 5 in rural southeast Kentucky can expect to live 11 fewer years than someone born in California District 19,” Lewis said. “That’s a pretty gigantic kind of inequality and we don’t hear about it that often.”

If you look deeper at the numbers, similarities between struggling districts emerge. The thing about Kentucky’s District 5: it’s demographic makeup doesn’t change much. Not at least since the days of Johnson. It’s still overwhelmingly white. It’s still overwhelmingly native-born. And the same goes for other areas battered by misfortune. In fact, every congressional district where more than 98 percent of residents are native-born clocked a below-average score on the Human Development Index — and have substantially shorter lives.

“One interesting finding is that, basically, the districts at the bottom are struggling rural and urban areas in the South that face economic isolation and concentrated poverty as well a history of disinvestment in education,” Lewis said. “They are overwhelmingly white. And they’re overwhelmingly U.S. born.”

This suggests that the best way to achieve a higher ranking would be to encourage higher rates of migration. Foreign-born migrants, any number of studies have shown, can inject a community with fresh vitality and even health. Immigrants don’t have many unhealthy habits — like fast food consumption — that saddle native-born Americans, the report noted. They also live markedly longer, especially Latinos and Asians. “The near-total absence of immigrants may be pulling down the life expectancy in this group of districts,” the report said.

Plus, Lewis said, “the migrants themselves are different. The sort of person who does that is brave and risk-taking.”

But in the case of Kentucky’s District 5, it’s not quite that simple, James P. Ziliak, director of the University of Kentucky’s Center for Poverty Research, told the New York Times. “One of the challenges that faces eastern Kentucky is the remoteness of the area,” he said. “It’s difficult to get to a lot of places. The communities are small, and they’re spread apart, so you lose that synergy that you want to spark development a lot of times. … My view is that firms will never locate into a community with an unskilled labor force, unless the only labor they need is unskilled. And there has been a historic lack of investment in human capital in these areas.”

So for now, the problems with struggling districts seems clear. Economic, cultural and demographic stagnation. The solution seems equally clear. Increase migration. But the question, however, remains troublesome: how to achieve it. “This matters because people hear about these differences and they think, ‘Too bad for them, and they forget about it,'” Lewis said. “But leaving different parts of the country behind is really costly. It pushes the American Dream out of reach for a lot of us. And it’s already costing us.”