There are a few ways to deal with the reality of the people affected by coal’s decline. You can give them phony promises that if we just cut environmental regulations, all the coal jobs will come back. You can just say their problems are all caused by a bunch of hippies or elitists.
Or you can try to create a modern economy that will offer jobs for people in those communities and give them things like health care and child care that will make their economic lives less harsh. Republicans have chosen the first and second; Democrats have chosen the third.
(The benefit of having a maverick like AOC in Congress is the ideas she pulls into public discussion. Politicians pay lip service to this stuff on the campaign trail. She champions the causes she fronted two years ago.)