I finished this last weekend. I found it really gripping and suspect the novel will sit with me for a long time. Very dark, but beautiful prose and character development. Kingsolver had a really interesting interview with Ezra Klein a couple years ago about the book and Appalachia which is worth checking out.
For a more uplifting view on the region, people can check out her book Animal, Vegetable, Miracle; which documents her journey of moving to Appalachia and eating locally for a year. Very mustachian and another gem from Kingsolver.