The photographic strategy in Appalachia USA: Photographs, 1968–2009 centers on capturing the evolving landscape and communities of the Appalachian region over four decades. Builder Levy’s black-and-white images present a nuanced exploration of rural life, revealing shifts in environment and culture through intimate portraits, architectural details, and scenes of everyday labor.

Levy’s work documents a region marked by resilience and transformation, offering visual narratives that encompass hope, hardship, and the passage of time. The photographs create a contemplative mood, emphasizing textures, light, and composition to highlight both the natural surroundings and the human presence within them. This collection spans 128 pages and was published by David R. Godine in 2013.