In retrospect, we learned all we needed to know about President Trump’s views of the U.S. military when candidate Trump smeared the Khan Gold Star family during the 2016 presidential campaign.

He reinforced that impression following the first military action he ordered – a covert SEAL mission in Yemen that resulted in the death of Senior Chief Petty Officer William “Ryan” Owens. First, Trump blamed his predecessor, President Obama, for initiating the mission, then he blamed U.S. generals for Owens’s death.

“They lost Ryan,” Trump told Fox News.

The president is the commander and chief of the U.S. military forces. Whatever the outcome of military action – the death of Osama bin Laden or the death of Chief Petty Officer Owens – the ultimate responsibility lies with the president. Trump was correctly criticized by current and former military members for saying “they” lost Ryan. A more honorable response would have been “We lost Ryan.”

Trump’s treatment of the military and its veterans should matter to West Virginians and residents of other Appalachian states, who are national leaders in two categories:  1) voting for Trump and 2) sending their sons and daughters into military service.

Just under 69 percent of West Virginians voted for Trump – the second-highest percentage of any state, right behind Wyoming. Appalachian states Kentucky and Alabama went 63 percent for Trump; Tennessee, 61 percent.

Appalachian states also boast high veteran populations. Nine percent of West Virginia residents are veterans, a figure that ties the state for second in the nation with a handful of other states, including South Carolina and Alabama. In Virginia, the number is 10 percent.

According to the U.S. Census, Southern states – many of them in the Appalachian region – are home to 40 percent of all U.S. veterans, the nation’s highest regional percentage by far.

This week, Trump was asked why he hadn’t performed the customary presidential role of Comforter in Chief for the families of the four soldiers killed in an ambush in Niger. In response, he once again used the situation to smear others and try to make himself look better.

In this Sept. 15, 2015, photo, then-candidate Donald Trump speaks during a campaign event aboard the retired USS Iowa in Los Angeles. The Associated Press reported that the Internal Revenue Service had revoked the non-profit status of Veterans for a Strong America (VSA), the group that hosted Trump’s speech. VSA is headed by Joel Arends, a veteran and conservative campaign operative. According to Rick Cohen, national correspondent for the Non-Profit Quarterly, VSA is not a legitimate veterans organization. “For Arends to claim that Veterans for a Strong America has a half-million members, or for Trump to tout its endorsement of his campaign as a statement of support from veterans, is embarrassing not just to the press, which didn’t dig into the organization’s veteran bona fides, but to the nonprofit sector, which seems to be plagued by 501(c)(4)s, super PACs, and even 501(c)(3)s that are willing to take advantage of the America public’s goodwill toward the men and women who served in the military.” (AP Photo/Kevork Djansezian)

Trump claimed, “The traditional way, if you look at President Obama and other presidents — most of them didn’t make calls,” he said. “A lot of them didn’t make calls.” This was a lie. Presidents Obama, Bush 41 and Bush 43, Clinton and every other president in memory has called or written to or personally visited the families of fallen soldiers. Obama routinely visited wounded soldiers at Washington D.C.’s Walter Reed National Military Medical Center. The sister of one soldier killed in Iraq took to Twitter to recall how President George W. Bush listened while she screamed at him and then hugged her while she sobbed.

Trump, on the other hand, said that he had “called every family of someone that’s died.” But The Washington Post contacted families of 13 of the at least 20 Americans killed in action since Trump took office. It found that only half of them said they had received calls from the president.

One of the calls Trump did make went disastrously wrong, according to the widow of a soldier killed in Niger.

Calling Myeshia Johnson, widow of Sgt. La David Johnson, Trump told the grieving woman that, while her husband’s death was painful, he “knew what he signed up for.”

On Twitter, Trump denied he said it, but the woman’s account was backed up by her mother and a member of Congress, who were in the car with her and heard the conversation with the president.

Why does all this matter? West Virginians and many other Appalachians put Trump in the White House. Trump prominently appealed to veterans and campaigned with generals. One might think he would treat military members and veterans with special care, not ignore and insult them, use them as cudgels to beat political opponents, and duck responsibility when they are killed under his command.

Yet, so far, Appalachians don’t seem to care. A recent survey of 470,000 Americans found that, although Trump’s approval rating has dropped in all 50 states over the course of his presidency, it remains positive in 16 states. Trump remains most popular in Wyoming, followed by West Virginia. Regionally, he remains most popular in the region of the country with the most veterans — the South.

This is puzzling. But maybe Trump’s constant charge that the mainstream media is fake news is sticking with his supporters, who believe his tweets over legitimate journalism. Maybe not forever, though. The recent survey of Trump’s approval rating was taken before his insensitive response to the deaths in Niger. And it was taken before this photo of Myeshia Johnson, hugging the coffin of her husband, her little girl standing next to her.

West Virginians understand suffering and loss in battle. The state was born from war, and West Virginia families have given more than their share in defending America. The government has nothing to give grieving West Virginia families to replace their loss. But presidents have always at least given their respect. Until now.

Frank Ahrens, a West Virginia native, is a public relations executive in Washington D.C. He was a Washington Post journalist for 18 years and is the author of “Seoul Man: A Memoir of Cars, Culture, Crisis, and Unexpected Hilarity Inside a Korean Corporate Titan.”

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This article was originally published by 100 Days in Appalachia, a nonprofit, collaborative newsroom telling the complex stories of the region that deserve to be heard. Sign up for their weekly newsletter here.