Works where the horror lurks in isolated, rural areas. May include a deeply inbred family, a Serial Killer or Serial Rapist (or both, seeing how Murderers Are Rapists) or maybe even a Cannibal Clan. The native environment of the Sackhead Slasher.
The default seems to be that the hillbillies themselves are the monsters, but this is not necessarily the case: some works will sympathize with the rural folk, but have them menaced by some monster or killer lurking in the wilderness, just outside the bounds of their community.
“Of course it follows the well-understood Hollywood moral of ‘don’t fuck with hillbillies’.”
— The Spoony Experiment about Pumpkinhead
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