West Virginia per year, with 1,400 of those statistically attributed to deaths from heart, respiratory and kidney disease from living in an Appalachian coal county. In 2015, McDowell County had the highest rate of drug-induced deaths of any county in the United States, with a rate of 141 deaths per 100,000 people. Four of the five US counties with the highest rates of drug-induced deaths are located in West Virginia (McDowell, Wyoming, Cabell and Raleigh Counties). West Virginia's capital and seat of government is the city of Charleston, located in the southwest area of the state. The West Virginia Legislature is bicameral.
West Virginia Route 4 Virginia via WV 20, US 33, WV 28, and US 50. West Virginia Route 4 West Virginia Route 4 is a north–south state highway within and maintained by the U.S. state of West Virginia. The southern terminus is at U.S. Route 119 in Clendenin. The northern terminus of the route is at West Virginia Route 20 in Rock Cave. The road connects several towns in the central part of the state. WV 4 is concurrent with U.S. Route 19 from Flatwoods to Ireland. WV 4 used to extend across the state, running west from Clendenin to Kentucky via US 119