In 1994 in upper north-east Adams county, local people relate thoughts of death with advanced age, hospitals, and nursing homes. Occasionally, there is an accident or irreversible medical problem involving a younger person. These infrequent occurrences receive much attention from the community. Widespread fear of infant mortality is not manifest.

However, in this same area, from colonial times until about 1920 death occurred in a more widely dispersed fashion: far from being merely the prospect of the elderly, death's inevitability was the unseen companion of young and old alike. Death could occur at random. Mortality was a distinct possibility for every child. The cultural effects of the ensuing, profoundly different perspective are evidenced in the area's music, art, and folk beliefs. [excerpt]