Yes. But I wouldn’t know that when I get the card.
I can only speak for myself, but I would think there is a specific connection to Kentucky that I don’t know about. To me it would feel as if I’m missing out on half the joke due to my lacking knowledge of Kentucky.
That’s what I thought too… I am more confused now 
I remember back in 2018 when we were watching Deadpool 2 in cinema, my friend who has Bachelor Degree in English Literature whispered to me, “I don’t understand. It’s so American, so comic book.” 
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I want to thank everyone for their replies. When you design a card, it kinda of becomes your baby and I needed to be reminded that not all people thinks your babies are as darling as you do. So I’ll be ordering a few of the My doctor told me to eat more fish cards, and maybe just 2 of the others to send to fellow American Postcrossers.
Thanks for the feedback.
I just used the last of my favorite PUN cards, but they weren’t specific to an area, more like play on words with an animal illustration. I always explained the PUN a bit, to help the recipient understand. I got a lot of positive feedback 
I live in the UK & have eaten Swedish fish as lot of our Supermarkets stock USA foods these days. i didn’t get the other two.