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The term "hillbilly" originated as a pejorative term for people who lived in isolation in mountainous regions of North America such as the Appalachian mountains and Ozarks. A less demeaning term would be "hill folk". The use of this definition was probably most valid between the western expansion and the 1940s. The advent of the interstate highway system and television brought these communities into mainstream United States culture in the 1950s and 1960s, but many communities with relatively traditional lifestyles remain throughout the region.

Historically, there were conflicts between the hillbillies and the planters who lived in the plains. During the American Civil War, the hill folk were almost uniformly pro-Union in that they generally did not own slaves and resented the political dominance of planters who did. This resentment lead to the creation of the state of West Virginia. This has also led to counties in hillbilly areas with pro-Union names such as Lincoln County or Union County.

Country and Western music was called hillbilly music, even by its fans, until the late 1950s. Now both terms have been supplanted by country music.

The hillbilly lifestyle was gently parodied in the 1960s American sitcom The Beverly Hillbillies were supposed to have come from near the Ozarks.

In modern terms a hillbilly is an individual characterized by being generally unrefined.

see also white trash