With 23 million people, nearly half of them rural, spread across 200 thousand square miles in the Appalachian mountains, Appalachia needs help shedding its backwoods image. That's where the federal-state partnership Appalachian Regional Commission (ARC) comes in. Its Area Development Program and Highway Program are designed to increase jobs and per capita income, improve economic competition, develop infrastructure, and reduce isolation in the region. Projects include improving local water and sewer systems, increasing health care access, creating jobs, and providing community strategic planning assistance. The forerunner to ARC was created by President Kennedy in 1963. It became official in 1965.