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Helicobacter pylori infection, an important etiologic factor in peptic ulcer disease (PUD), is present in about half of the world's population. In the U.S., the prevalence of such infection has declined in recent decades, likely because of improved living standards and increased use of antibiotic therapy. The incidence of PUD has also declined, probably related to the decreased prevalence of H. pylori infection and to the abundant use of histamine-2–receptor blockers and proton-pump inhibitors. However, as a consequence of regional differences in socioeconomic status and demographic factors, these declines might not be geographically uniform. To examine this issue, researchers studied rates of H. pylori infection and PUD in a rural, socioec…