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The rationale for studying Appalachian residence in addition to rural residence is that while the Appalachian region faces similar challenges to rural areas, it is a unique geographical area of historical independence and resilience, with health disparities in Appalachia especially pronounced in part due to its well-documented social disadvantages, history of economic exploitation, and increased environmental exposure 19

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however, there is a lack of strong proof regarding their effects, with several doubts raised for the likely miscomprehension of these herbs as being safe