After 4 years of operation, the Appalachian Regional Commission (ARC) presents this 1969 annual report and evaluation of its activities as required by the Appalachian Regional Development Act of 1965. A brief overview is given of the history of the program, the Federal-state relationship, and strategies for regional development. Appalachia is then described in terms of education, health, children and youth, manpower development, rural programs in transportation, community facilities and housing, natural resources, local development districts, and regional economy. Also discussed are research, technical assistance, and planning. Appendices provide population data, a bibliography of research publications by the ARC, and breakdowns of funding for ARC-approved projects. (LS)