This is very interesting to read. How do you think these conservative Democrats vote at the presidential level?
Obama did not do that much worse than Kerry, Gore, or Clinton in Western NC, unlike the rest of Appalachia. Madison County was almost 50/50 in 2008 and Madison County is as redneck as it gets. I think Hillary would manage to actually win some counties in NC's mountains, aside from Buncombe, Watauga and Jackson.
Summary:
So more hippy-like left wing groups, more colleges and universities, and native Americans in some cases. Very isolated locations that have kept the democratic tradition there for decades and not aligning with Tennessee in the pro-union fashion that they used to. Thanks psychicpanda and Sol for giving good answers.
Another possible reason is the influence of the federal government in Western NC. The Great Smoky Mountains National Park is a HUGE tourist attraction and the only thing supporting the local economy in Swain, Jackson and Haywood Counties. There's also the Blue Ridge Parkway which lifted much of rural Western NC out of darkness. Both were created under federal programs by FDR. Now, you could argue, the TVA helped Eastern Tenn. just as much. But there's no doubt people in NC's mountains are appreciative that the federal gov't pours money into their region.