Coal River Mountain as seen from nearby Kayford Mountain. Photo courtesy of Coal River Mountain Watch.
There’s another new study out from West Virginia University’s Michael Hendryx, this one reporting, based on a community survey in the Coal River area of Boone and Raleigh counties:
Self-reported cancer rates were significantly higher in the mining versus non-mining areas after control for respondent age, sex, smoking, occupational history and family history.
Mountaintop mining is linked to increased community cancer risk. Efforts to reduce cancer and other health disparities in Appalachia must focus on mountaintop mining portions of the region.
The study, “Self-Reported Cancer Rates in Two Rural Areas of West Virginia with and without Mountaintop Coal Mining,” (subscription required) was published online in the Journal of Community Health.
Map of study areas. Cross-hatched areas indicate the approximate locations of survey activities
The paper is not without its limitations. The authors explained:
Study limitations include those relating to survey sampling procedures and the extent of questions asked. Contact attempts at most households occurred only once, and survey times did not include late evenings and weekends because of the logistical and cost difficulties involved in transporting and housing the student volunteers. This could result in survey respondents in both locations that are not necessarily representative of the entire populations. Survey procedures, however, were comparable in both communities and so would not be expected to result in an overestimate of cancer in Coal River relative to Pocahontas. Asking people if they have ever had cancer limits the cancer experience to survivors. Information on persons who died from cancer was not collected, which may explain why some cancer types such as lung cancer were observed rarely in the sample. In other research, higher lung cancer mortality in coal mining portions of Appalachia has been documented.
The survey included limited information on covariates. The preference among the community research partners was to keep the survey brief so that as many surveys as possible could be collected in a short time. There were concerns expressed by community partners that if the time spent per survey was prolonged, such that fewer surveys could be completed/day and more time had to be spent in Coal River to collect an adequate sample size, word about the survey taking place would reach the coal industry, and community residents would be instructed or pressured by industry representatives not to take part. Limited covariate data precluded investigating the possible impacts of such variables as obesity or health care access on cancer.
After data collection the research partners convened to discuss how the study process could be improved for possible replication in other communities. There was agreement that future efforts should attend to data collection during weekend and evening times, and how some additional data would have been worth the extra survey time to collect. In addition to extra covariates such as obesity, community partners expressed the importance in future studies of collecting cancer data not just on biologically-related family members but on spouses, as they knew of cases where a husband or wife had recently died of cancer, but these data were not collected in the survey. These discussions illustrate the utility of the community-based participatory model in helping both parties (academic researchers and community residents) learn from each other to make research efforts more practical and effective.
The paper concludes:
There are 1.2 million people who live in mountaintop coal mining counties in central Appalachia based on 2010 US Census data. If the rates found in this study represent the region, a 5% higher cancer rate (14.4% vs. 9.4%) translates to an additional 60,000 people with cancer in central Appalachian mountaintop mining counties. On a national level, the difference between 11.2 and 3.9% (the rates in the Coal River sample and the US, respectively, not including non-melanoma skin cancers) translates to an additional 87,600 people with cancer in central Appalachian mountaintop mining areas compared to national rates. Although, these projections are uncertain, they illustrate the large numbers of people who are potentially impacted by mountaintop mining environments.
The people of Appalachia constitute a nationally recognized priority population for the elimination of health disparities. The results of this study and others previously cited on coal mining populations demonstrate that health disparities are concentrated in mountaintop mining areas of the region; clearly, the national goal to eliminate Appalachian health disparities will not be achieved unless disparities are eliminated in mountaintop mining areas.