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Owing to intense hunting pressure, the population declined rapidly.
Perhaps as early as the 1840s, at any rate by 1870, all heath hens were extirpated on the mainland.
There were about 300 left on the island of Martha's Vineyard, off Massachusetts, but by 1890 this number had declined to 120-200 birds, mainly due to predation by feral cats and poaching.
By the late 19th century, there were about 70 left.
These were protected by a hunting ban and by the establishment in 1908 of the " Heath Hen Reserve " ( today the Manuel F. Correllus State Forest ), and the population rapidly grew to almost 2000: by the mid-1910s, observing the birds on their lekking grounds had become something of a tourist attraction.
However, a destructive fire during the 1916 nesting season, severe winters, an unusual influx of predatory goshawks, inbreeding, an excess number of male individuals and apparently an epidemic of blackhead disease, which might have been transmitted by poultry, brought the numbers down quickly ; after a last recovery to 600 in 1920, the population began its final decline.

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