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This project demonstrated how a nutritional disease such as pellagra can be tied to geography, and how geography contributes to a sense of identity in addition to a sense of togetherness or otherness. People can be very tied to where they come from. This can lead to a shunning of outsider opinions or support. Future research comparing pellagra in the American South to other epidemics, such as in Italy or Romania, and the differences in views towards pellagrins could be insightful. In both cases, it was viewed as a disease that only affected poor people.