A family of Hatfields (very common name here) comes into the Tug River Childrens Clinic in Pine hill for checkups and flu shots. Many of these families struggle with chronic disease, poor nutrition, high rates of infant mortality and environmentally based health conditions. Yet, due to extreme isolation and harsh terrain, they also face considerable difficulties accessing health care. Cardiovascular disease at all ages, obesity and asthma are persistent health challenges in the area.