Does the coal industry’s new report ‘debunk’ WVU studies on mountaintop removal and public health?

February 15, 2012 by Ken Ward Jr.

UPDATED:HERE’S today’s Gazette print story about this study.

As noted last night in Coal Tattoo’s comments section, a Yale University researcher hired by the National Mining Association has published the first peer-reviewed paper that offers a response to the 20 papers that West Virginia University’s Michael Hendryx has produced over the last four years exploring the links between living near mountaintop removal mines and facing increased risks of health problems, including cancer and birth defects.

The paper, by Dr. Jonathan Borak and others, is called “Mortality Disparities in Appalachia: Reassessment of Major Risk Factors.”  It’s published in this month’s Journal of Occupational and Environmental Medicine, with its abstract available for free here. As frequent Coal Tattoo reader and commenter Casey pointed out, the industry consulting group Environmental Resources Management Consulting has helpfully posted the entire paper on its company website.

Here’s the abstract, which describes the study’s objective, methods, results and conclusions:

Objective: To determine the predictive value of coal mining and other risk factors for explaining disproportionately high mortality rates across Appalachia.

Method: Mortality and covariate data were obtained from publicly available databases for 2000 to 2004. Analysis employed ordinary least square multiple linear regression with age-adjusted mortality as the dependent variable.

Results: Age-adjusted all-cause mortality was independently related to Poverty Rate, Median Household Income, Percent High School Graduates, Rural–Urban Location, Obesity, Sex, and Race/Ethnicity, but not Unemployment Rate, Percent Uninsured, Percent College Graduates, Physician Supply, Smoking, Diabetes, or Coal Mining.

Conclusions: Coal mining is not per se an independent risk factor for increased mortality in Appalachia. Nevertheless, our results underscore the substantial economic and cultural disadvantages that adversely impact health in Appalachia, especially in the coal-mining areas of Central Appalachia.

Now, we’ve yet to hear anything from the National Mining Association trumpeting the findings. I have to express some shock that it hasn’t shown up on West Virginia MetroNews or in the Daily Mail yet. Maybe the NMA has learned from its previous problems attacking Dr. Hendryx, like the time the industry’s law firm tried to suggest that any increased rate of birth defects in Appalachia was caused by inbreeding.

Some readers may recall that about two years ago, the industry lobby went kind of crazy about a preliminary analysis that Dr. Borak did for them, with the NMA’s PR outfit “tweeting”:

Yale professor debunks bogus studies on the health effects of Appalachian surface mining.

When asked about it, Dr. Borak said his studies did no such thing and that he had never referred to the work by WVU’s Hendryx as “bogus.” The National Mining Association retreated, and apologized for its PR tactics.

Now, it’s important to note that this paper by Dr. Borak was peer-reviewed, and it’s published in a respected journal. That’s the way science is supposed to work. And the Borak paper is up-front about who funded it, saying right on the first page:

The study was supported by the National Mining Association.

It also says:

Its results presented here represent the conclusions and opinions solely of the authors. Its publication does not imply endorsements by the National Mining Association. The study sponsor had no role in the study design, analysis or interpretation of the data, or in the writing, preparation, or submission of the manuscript, which was not provided to the sponsors prior to its submission for publication.

So what does it say? Well, here’s some from the beginning, where Dr. Borak and his co-authors explain what they set out to do:

A recent series of ecological studies by researchers at West Virginia University (WVU) has suggested that age-adjusted Appalachian county mortality rates are independently related to the presence of coal mining, but the nature of that relationship was uncertain. Increased mortality rates were apparently not due to occupational exposures and observed mortality patterns differed between Appalachian coal-mining counties and coal-mining counties outside Appalachia. For example, county-level lung cancer mortality was elevated in Appalachian, but not in non-Appalachian coal mining areas. The WVU authors proposed that observed health disparities in residents of Appalachian mining areas might be attributed to a “coal mining–dependent economy,” or to “pollution” and the “environmental impacts of Appalachian mining,” or to “additional behavioral or demographic characteristics not captured through other covariates.”

To better understand these possibilities, particularly the role of coal mining as an independent risk factor for disparate mortality rates, we undertook a reanalysis of those published studies. Our objective was to determine the predictive value of coal mining and other potentially relevant risk factors for explaining differences in mortality rates across the Appalachian region.

And here’s the basis summary of what they found in two different model runs:

— These findings indicate that higher age-adjusted all-cause mortality rate was independently related to Poverty Rate, Percent High School Graduates, Rural–Urban Location, and Demographic variables including Sex and Race/Ethnicity rates. Mortality Rate was not significantly related to Percent College Graduates, Physician Supply, or Smoking Rate.

And:

These findings indicate that higher age-adjusted all-cause mortality rate was independently related to Poverty Rate, Median Household Income, Percent High School Graduates, Rural–Urban Location, Obesity Rate, and Demographic variables including Sex and Race/Ethnicity rates. The relationship between Mortality Rate and Percent College Graduates was nearly significant (P = 0.0814), but Mortality Rate was not significantly related to Physician Supply, Smoking Rate, or Coal Mining: Yes/No.

And further analysis found:

… We considered the effects of including either of the twomeasures of coal mining in the Further ExpandedModel. Neither Coal Mining:Yes/No nor Coal Mining: High/Low/None significantly improved the explanatory power of the model. The findings of this analytical model argue that coal mining is not per se an independent risk factor for increased mortality in Appalachia. By contrast, we found that increased mortality was significantly associated with greater poverty, lower median household income, fewer high school graduates, rural location, obesity rate, and demographic factors including sex and race. Lower college graduate rate was nearly significant. Moreover, we found no significant associations for smoking, physician supply, and diabetes.

And here’s how they explained the differing results concerning coal mining’s impacts:

The WVU studies each defined different coal-mining categories. One defined coal-mining areas as “counties with any amount of coal mining” during 1994 to 2005; some analyses also grouped coal-mining counties into those above and below the median production level. A second study defined three groups of counties based on total 2000 to 2004 coal production: more than 3 million tons; less than 3 million tons; and no production. For some analyses, counties with more than 3 million tons of production were compared with all other counties combined and “per capita coal production” (calculated relative to the 2000 census) was also included in those analysis. The third study also defined three groups of counties on the basis of total 2000 to 2004 coal production, but groups were defined differently: more than 4 million tons; less than 4 million tons; and no production. Our approach was similar to the first of those WVU studies, but we considered the time span considered in the latter two studies. Our analysis divided counties into two groups based on whether any amount of coal was mined during 2000 to 2004, and coal-producing counties were further grouped into those above and below the median production level for Appalachian counties during that time period.

Our Expanded Model indicates that coal mining is not per se the cause of increased mortality in rural Appalachia. On the contrary, our results underscore the substantial economic and cultural disadvantages that adversely impact the health of many area residents. Particularly in the coal-mining areas of central Appalachia, there is a potent combination of greater economic distress, lesser educational attainment, decreased access to health care, limited availability of nutritious foods, higher rates of behavior-related risks such as obesity and smoking, and decreased use of preventive health services.

But here’s where things start to get more interesting:

Such overlapping risk factors and mortality rates illustrate how difficult it can be to disentangle the effects of the cultural environment from those of the physical environment, a difficulty made greater because the two interact. For example, the physical isolation of the mountainous counties that characterize rural Appalachia poses barriers to industrial diversification and broadening of employment options, and also contributes to lower incomes, reduced access to health care services, reduced availability of nutritious foods, and so forth. The interplay of geographical isolation,
kinship, and health-related behaviors further complicates matters. Rural Appalachia is distinguished by tight-knit social networks, “cohesive, extended, and geographically connected” kinships, which often extend beyond biological families. Such networks can exert significant influence on the behaviors and health of their individual members, as recently documented in the Framingham Study. In that well-studied New England community, risks of becoming obese (ie, the “induction and person-to-person spread of obesity”) were predicted by the closeness of social relationships, not by “common exposure to the local environment.” Thus, the physical environment (eg, geographical isolation) can foster cultural practices (eg, tightknit kinships) that promote adverse health outcomes (eg, obesity).

The authors continued:

Accordingly, coal mining in Appalachia, an industrial activity associated with rural, mountainous areas, is likely to be geographically associated with a variety of economic and cultural health risk factors. And, for similar reasons, mining is also likely to be geographically associated with a variety of adverse health outcomes. Although our results indicate that mining is not the direct cause of those outcomes, they do not rule out the possibility that mining contributes to the development of the social environments and cultural practices that adversely impact health.

And here’s the kicker:

This possibility seems most likely in those specific areas where mining is the principal industry. Likewise, our analyses do not rule out the possibility that some specific mining methods may have greater adverse effects than others on the physical environment.

Finally, they conclude:

Ultimately, the issue of greatest concern is that Appalachians suffer disproportionately poor health and increased risks of adverse health outcomes compared with the rest of the nation. During the past 50 years, ARC and others have overseen substantial improvements in the well-being of regional residents. Nevertheless, significant shortfalls persist. To eliminate health-related disparities, substantial efforts must be directed at the region’s underlying economic
and social disparities. To the extent that coal mining is factor in defining the cultural fabric and socioeconomic environment of Appalachian communities, the coal-mining industry must play a role in efforts to increase economic diversity, develop job-creation programs, ensure access to appropriate heath care services, improve educational opportunities, and facilitate access to nutritious foods and diets.

My friend Andrew Revkin, who does the DotEarth blog, has often written and talked about the “whiplash” effect of media coverage of scientific papers about global warming and other important public policy debates:

Unfortunately, when research on tough questions sits under the microscope because of its relevancy to policy fights, the impact on the public can be a severe case of whiplash. Journalists and campaigners succumbing to “single-study syndrome” in search of a hot front-page headline or debating point threaten to alienate readers seeking some sense of reality.

Environmental groups, coalfield citizens — human rights activists to use the term some of them prefer — have been sometimes over the top in their description of what Dr. Michael Hendryx has found (see the comments section here).  Is there any doubt that the coal industry hasn’t, well, exactly acted very honorably, in terms of trying to distort things and pollute the public discourse over what is clearly an important issue?

Personally, I’m hoping to soon get an email or a call back from Dr. Borak to talk to him about his paper. I’m hoping to get Dr. Hendryx on the phone to get his response, and I hope to soon reach a few independent public health experts who can give me their views on the matter. As I wrote earlier today in response to Casey’s comment:

… These findings do absolutely nothing to diminish the need for public officials in the region to pay attention to this scientific discussion. It would be great if Sen. Rockefeller held a hearing and invited Dr. Hendryx and Dr. Borak to testify about their work, explain the differences and the implications, and help educate the public and policymakers on what all of this means.

What the coal industry wants right now is for the scientists they fund to churn out papers that they can use in a PR effort to discredit the work of Dr. Hendryx. what citizen groups want is to discredit those industry-funded papers.

Those interests are quite different from the needs of the actual public. What the public needs is for policymakers and the media to work on helping them understand what the science means and what sorts of public policies it suggests be followed.

41 Responses to “Does the coal industry’s new report ‘debunk’ WVU studies on mountaintop removal and public health?”

  1. Ken Ward Jr. says:

    Folks,

    Here’s something interesting I noticed is posted on the website of that industry consulting firm. Ken.

    http://www.ermc2.us/news_view.php?news_id=59

    Feb 7th, 12
    Mortality Disparities in Appalachia

    Bruce Watzman, Senior Vice President, Regulatory Affairs

    The Journal of Occupational and Environmental Medicine today posted a “published ahead of print” article that will appear in the Journal later this month reporting on a study conducted by Dr. Jonathan Borak, a clinical professor of epidemiology and medicine, and several of his Yale University colleagues titled, “Mortality Disparities in Appalachia: Reassessment of Major Risk Factors.” A pre-publication copy of this article, which examines the role of coal a factor in Appalachian mortality rates, is attached for your information.

    The study, which was partially supported by the National Mining Association, concludes that:

    Coal mining is not per se an independent risk factor for increased

    mortality in Appalachia.

    The study goes on to conclude:

    To the extent that coal-mining is a factor in defining the cultural fabric and socioeconomic environment of Appalachian communities, the coal-mining industry must play a role in efforts to increase economic diversity, develop job-creation programs, ensure access to appropriate health care services, improve educational opportunities and facilitate access to nutritious foods and diets.

    Background
    In 2008, Dr. Michael Hendryx, a psychologist at West Virginia University, began publishing a series of studies alleging that coal mining was the cause of, or a contributing factor to, a series of adverse health outcomes identified in several Appalachian coal mining communities.
    On two occasions, the National Mining Association (NMA) retained the services of expert consultants to critique Dr. Hendryx work. NMA’s consultants, which included trained and practicing epidemiologists and biostatisticians, identified “factual discrepancies and methodological flaws” in Dr. Hendryx’s studies and accompanying articles. The consultants highlighted Dr. Hendryx’s (1) failure to consider important covariates; (2) use of outdated databases for analysis; and (3) failure to establish a causal relationship between the identified outcomes and coal mine exposure.

    Despite identification of the study defects, Dr. Hendryx’s work continues to be cited by mining opponents as a basis for rejecting mining permits. While these efforts were initially limited to permit disputes in Appalachia, the Environmental Protection Agency and environmental groups outside Appalachia have begun to cite the alleged health outcomes in Dr. Hendryx’s studies as the basis for opposing new mining permits or the extension or expansion of existing permits.

    Last year, Dr. Borak approached NMA to seek partial support for a reassessment of the major risk factors identified or not identified in the earlier Hendryx work. In agreeing to this request it was understood that NMA would not be involved in the study design, analysis of the results or preparation of any publications.

    Dr. Borak’s results, based on an analysis of all known covariates and undertaking a linear regression analysis, “… underscore the substantial economic and cultural disadvantages that adversely impact the health of many [coal mining] area residents.” In sum, rather than singling out coal mining, as was the conclusion reached by Hendryx et al, Dr. Borak believes it is the confluence of several factors, i.e. economic distress, lesser educational attainment, decreased access to health care, etc., that contribute to the adverse health outcomes in many of these communities.

    We are advised that Dr. Borak has discussed the study with the Associated Press and that an article may be forthcoming. It would be advisable that we defer to him to ensure the properly characterization of the study methodology and findings.
    We will continue to analyze Dr. Borak’s work and welcome your thoughts once you have had a chance to review the study.

  2. Ken Ward Jr. says:

    Hey folks,

    Interestingly — that particular link has been removed from the consulting firm’s website. Good thing I pasted the information here, huh?

    Ken.

  3. Ken Ward Jr. says:

    Of note is that Casey appears to have quoted directly from Bruce Watzman’s memo, and not from the study itself. Ken.

  4. Bill Howley says:

    It appears from the information you have provided in your post that the Borak study is simply a further refinement of Hendryx’s work. I don’t have the knowledge or skills to compare their methodologies or statistical analysis. As you say, Ken, this is the main reason why we have to have a public discussion with experts about these studies.

    I was struck by Dr. Borak’s main qualification in his basic conclusion: “Our Expanded Model indicates that coal mining is not per se the cause of increased mortality in rural Appalachia.”

    The Latin expression “per se” means “by itself.” This is not an earthshaking conclusion. Public health outcomes always involve social dimensions, covariance and correlation with a wide range of factors. The real question is how and why they interact.

    It seems that the research is proceeding as it should. I wish we had political leaders in our state who would promote the kind of discussion that we need about these public health studies and the issues they raise.

  5. Soyedina says:

    To follow up on Ken’s last comment, Casey’s remark is predicated on the analyses made by the NMA consultants and not (necessarily) Borak. It’s not clear whether Dr Borak is one of the expert consultants retained by NMA, but from the memo it appears that the conclusions cited by Casey preceded Borak’s reassessment of his analyses.

    Bill Howley, agreed!

  6. Ken Ward Jr. says:

    Bill and Soyedina,

    As I wrote previously, this issue is now perfectly set up for a congressional fact-finding hearing — surely Sen. Rockefeller will invite Drs. Hendryx and Borak to education policymakers and the rest of us on their work.

    Ken.

  7. Montanus says:

    I also thought that this was an important element of their discussion, suggesting that “the possibility that mining contributes to the development of the social environments and cultural
    practices that adversely impact health … seems most
    likely in those specific areas where mining is the principal industry” (p. 154 / p. 9 of PDF):

    Although our results indicate that mining is not the direct cause of
    those outcomes, they do not rule out the possibility that mining contributes to the development of the social environments and cultural
    practices that adversely impact health. This possibility seems most
    likely in those specific areas where mining is the principal industry.
    Likewise, our analyses do not rule out the possibility that some specific
    mining methods may have greater adverse effects than others
    on the physical environment.

    http://www.ermc2.us/images/files/JOM201462_final.pdf

  8. Robin B says:

    This discussion reminds me of the proverbial question: “which came first – the chicken or the egg?” In that both “sides” identify other factors besides coal mining which could be related to increased risk of health problems amongst residents of coal mining communities, and – yet – both “sides” agree that there is a significant risk of said health problems, why is it not obvious that decades of mono-economic domination by the coal industry has brought about the very social and environmental and economic problems that contribute heavily to the dramatically increased risk of health problems? Whether chicken, or egg… both are fowl – just as foul as coal industry domination. It is well past time for progressive measures to bring about economic diversification and truly sustainable energy production in this state – my home state for me and at least 8 generations of my family.

  9. Frank says:

    And so what about consanguinity?

  10. Casey says:

    Ken,
    You stated that various groups “have been sometimes over the top in their description of what Dr. Michael Hendryx has found”. Maybe those groups include you when you repeatedly use the phrase “the growing science that links living near mountaintop removal mining to being at greater risk of cancer or birth defects” or the “growing body of evidence”.

    Borak said about Hendyrx “If he wants to say it’s coal mining, he can say that, but I’m not sure he’s correct”. There are a lot of social problems related to health in West Virginia that need addressed. I do not think using these problems as any opportunity to attack coal, that provides so much opportunity for many families, is proper, prudent or helpful but is indeed the opposite of those things.

  11. Ken Ward Jr. says:

    Casey,

    Thanks for the continued discussion, and again for pointing out the final version of Borak’s paper had been published.

    I’m never quite sure that you bother to actually read the materials we’re discussing here … it’s clear from your post the other night that you didn’t read Borak’s paper before posting about it, and your comments were based only on that the NMA’s lobbyist told the industry.

    As noted Soyedina noted about about these particular comments you made:

    “One study states that in sum, rather than singling out coal mining, as was the conclusion reached by Hendryx et al, Dr. Borak believes it is the confluence of several factors, i.e. economic distress, lesser educational attainment, decreased access to health care, etc., that contribute to the adverse health outcomes in many of these communities. Trained and practicing epidemiologists and biostatisticians identified “factual discrepancies and methodological flaws” in Dr. Hendryx’s studies and accompanying articles. They highlighted Dr. Hendryx’s (1) failure to consider important covariates; (2) use of outdated databases for analysis; and (3) failure to establish a causal relationship between the identified outcomes and coal mine exposure.”

    Those comments are taken almost word-for-word from Bruce Watzman. Those specific criticisms did not appear in Borak’s peer-reviewed paper, perhaps for the obvious reasons that they aren’t really that significant to scientists.

    In your latest comment, you write:

    “You stated that various groups “have been sometimes over the top in their description of what Dr. Michael Hendryx has found”. Maybe those groups include you when you repeatedly use the phrase “the growing science that links living near mountaintop removal mining to being at greater risk of cancer or birth defects” or the “growing body of evidence”. ”

    Did you click through to the link? If you had, you would have found a commentary by my buddy Jeff Biggers, who as I wrote before led his commentary with:

    “Among the 1.2 million American citizens living in mountaintop removal mining counties in central Appalachia, an additional 60,000 cases of cancer are directly linked to the federally sanctioned strip-mining practice.”

    http://blogs.alternet.org/speakeasy/2011/07/27/breaking-new-study-links-mountaintop-removal-to-60000-additional-cancer-cases/

    As explained in the comments section, that’s quite a stretch from what Dr. Hendryx actually wrote in his paper — and my news story and blog post about that paper much more accurately reflected what Dr. Hendryx did write.

    You take issue with my phrases:

    “…the growing science that links living near mountaintop removal mining to being at greater risk of cancer or birth defects” and

    “the growing body of evidence.”

    Well, the science by Dr. Hendryx started back in 2007, with a paper that showed:

    “… The volume of coal mining was significantly related to hospitalization risk for two conditions postulated to be sensitive to exposure: hypertension and chronic obstructive pulmonary disease (COPD). The odds for a COPD hospitalization increased 1% for each 1462 tons of coal, and the odds for a hypertension hospitalization increased 1% for each 1873 tons of coal.”

    Since then, there have been at least 19 other studies, with the body of science growing to include much more specific studies that showed, after adjusting for other factors, people living near mountaintop removal mines were more likely to have cancer or birth defects.

    Any reasonable person would agree that 20 papers published over a five-year period by Dr. Hendryx and a variety of other co-authors at other institutions in major peer-reviewed journals constitutes a growing body of science … each new study adds to the knowledge base, providing a “growing body of evidence” on the topic.

    And again, it appears to me you haven’t read the Borak study … if so, you would be criticizing it for the very words that Montanus quotes above:

    ” … The possibility that mining contributes to the development of the social environments and cultural practices that adversely impact health … seems most likely in those specific areas where mining is the principal industry””

    What does this mean? Well, you wrote about mining providing “so much opportunity for many families,” but Borak and his authors are cautioning that coal might actually be contributing to the very social problems that you claim to be concerned about. This paper if far from a clear-cut “debunking” of Dr. Hendryx and is well worth giving a look. It will be especially interesting to see what sort of response Dr. Hendryx provides to the JOEM … that’s the way science is supposed to work.

    Ken.

  12. Bo Webb says:

    Bottom line; there is enough scientific evidence to justify, if not demand a health study. No matter how one may view these different studies they both agree there is a health problem . I am of the opinion as I have said many times that the fallout from mountaintop removal blasting is the major contributor to the growing health crisis we are experiencing. It doesn’t matter if you are obese, poor, uneducated, or have minimum access to health care; if you live beneath or near mountaintop removal blasting you are breathing a variety of toxic particulates that are harmful to your health. Any clear thinking person can conclude that any community breathing the fallout of this blasting dust over a long period of time will have elevated health concerns. A federal government sponsored health study is needed to identify the cause and effect of this very serious problem. This matter should have the highest priority not only to Senator Rockefeller, but to Senator Manchin, and especially to Congressman Rahall. It is his district that ranks second to last in the nation in health disparities. In the meantime, in the interest of public health there should be an immediate moratorium on all mountaintop removal operations.

  13. Soyedina says:

    Bo, that’s a great idea. Ken covered this elsewhere on his other blog but last week in Nature a study (here is a summary, I believe the article is behind a paywall: http://www.nature.com/news/air-sampling-reveals-high-emissions-from-gas-field-1.9982) was published that provided evidence that gas wells are emitting large amounts of methane that are at least twice the amount estimated by other methods.

    The first clues appeared in 2007, when NOAA researchers noticed occasional plumes of pollutants including methane, butane and propane in air samples taken from a 300-metre-high atmospheric monitoring tower north of Denver. The NOAA researchers worked out the general direction that the pollution was coming from by monitoring winds, and in 2008, the team took advantage of new equipment and drove around the region, sampling the air in real time. Their readings led them to the Denver-Julesburg Basin, where more than 20,000 oil and gas wells have been drilled during the past four decades.

    Other researchers of course question whether these sites are representative, but the innovative thing is using this technique. Ambient air monitoring near surface mines or blast sites would be very interesting, you know as well as anyone that living under such a beast puts you in particle’s way but it might be that these particles travel much further than you suspect.

    P.S.- how anyone can deny that there is a “growing body of evidence that links living near mountaintop removal mining to being at greater risk of cancer or birth defects, or environmental and ecological damage” is completely beyond my ability to understand. If this is not a “growing body of evidence”, what would be?

  14. Carl Mullins says:

    Mr. Ward, how can anyone accept you as a fair and accurate source of facts and information when you’ve spent your life’s work trying to destroy the mining industry? You are no more a dependable source of facts than those who’s sole purpose is to defend the mining industry. An independant source of honest, truthful and factual information would be wonderful but I don’t expect it in this our side vs your side society we live in.

  15. Bo Webb says:

    Carl, Ken gets it from both sides. He is the best factual journalists covering the mining industry, bar none. If you have something you can reference that he has said that is not factual please share it with all of us. I certainly don’t agree with everything that he writes but I have never found him to not be factual. A reporters responsibility is to report the truth according to the facts. I doubt there is another reporter in the US that digs for the truth and has the credible resource data pertaining to the coal industry than Ken Ward. Frankly, I don’t get your point, he is simply reporting on Borak’s research, what’s the problem with that?

  16. AlexM says:

    It is amazing that you trash the coal mining industry every single day, and at the same time enjoy all the benefits of the electricity produced by the coal. You should thank every single day to all these coal miners, the true American heroes, for providing us with the electricity so we can enjoy all the benefits the civilization can bring.

  17. AlexM says:

    To be honest to you, I have never seen such negative journalist in my entire life. It is simply astonishing that you have never written any single positive article, or even a paragraph, about the coal. No industry is perfect, you can find so many problems in any of them. You can also find some incompetent people in any of these industries. However, you cannot simply see the big picture and recognize an enormous contribution of coal mining to the state of West Virginia. What is particularly interesting in this great state is that every single year both Democrat and Republican candidates get almost 98 % of votes, and all of them are strong supporters of coal mining industry. How is that possible that Mountain party candidate gets less than 2% every single election? It appears that the people of West Virginia are very smart and vote for those who will protect their interests. They are aware that 97% of electricity in WV is produced by the coal.

  18. Casey says:

    Ken writes ”but Borak and his authors are cautioning that coal might actually be contributing to the very social problems that you claim to be concerned about.” Please explain how that “might” work exactly.

    Anyway so coal might be causing social problems therefore let’s stop mining. Is that the conclusion?

    What sort of social problems do you think would result if coal mining was stopped in Southern WV? How do you think massive unemployment and loss of tax base would affect the issues that Borak wrote about like “greater economic distress, lesser educational attainment, decreased access to health care, limited availability of nutritious foods, higher rates of behavior-related risks such as obesity and smoking, and decreased use of preventive health services”?

    A growing body of non-government entities that thrive and provide economic benefits and jobs are the best medicine for what ails the coal fields.

  19. Ken Ward Jr. says:

    Casey,

    It seems that this industry-funded study you were so eager to trumpet has come back to bite you … sorry about that. Next time, you might read the whole thing first, before you simply quote what our friend Bruce Watzman says about it …

    Regarding your latest comment, it’s difficult to have much of a discussion with you when your so quickly revert to throwing up straw-men arguments about stopping all coal mining, instead of focusing on the paper we’re discussing and what it actually says.

    We should all be watching for what Mike Hendryx writes in response to this Borak paper, to help us understand more fully the differing data and methods they used — so that we can see how it is they came up with some differing conclusions.

    But these passages from Borak’s paper are fascinating and worth everyone reading again:

    “… Coal mining in Appalachia, an industrial activity associated with rural, mountainous areas, is likely to be geographically associated with a variety of economic and cultural health risk factors. And, for similar reasons, mining is also likely to be geographically associated with a variety of adverse health outcomes. Although our results indicate that mining is not the direct cause of those outcomes, they do not rule out the possibility that mining contributes to the development of the social environments and cultural practices that adversely impact health. This possibility seems most likely in those specific areas where mining is the principal industry.
    Likewise, our analyses do not rule out the possibility that some specific
    mining methods may have greater adverse effects than others
    on the physical environment.”

    How does mining perhaps contribute to the development of the social environments and cultural practices that adversely impact health?

    Well, this isn’t exactly a new idea … Some scholars have offered “the resource curse” as an explanation (see some basic discussion of this here (http://en.wikipedia.org/wiki/Resource_curse ). It’s simply the notion that being rich in natural resources like coal, natural gas and timber has made us dependent on those resources, and allowed us to avoid having to do the harder work of diversifying our economy, improving our educational system, and otherwise doing the things that might make Appalachia more healthy, successful and rich, in money and in so many other things.

    Questions about Borak’s methods aside (see my print story here http://wvgazette.com/News/MiningtheMountains/201202150188 ), it is remarkable to see the coal industry’s hand-picked own consultant publish a paper that raises these issues. I’m not sure this is exactly what the National Mining Association was looking for — and like Casey, it may come back to bite them.

    Ken.

  20. AlexM says:

    Mr, Ward,
    It is remarkable, indeed, to see that you don’t understand that coal industry cannot decide whether the paper will be published or not in the peer-reviewed journal. That decision is made by the editor-in-chief based on the recommendations of the independent reviewers, i.e. experts in that field. The Journal of Occupational and Environmental Medicine where Dr. Borak’s et al paper will appear is not owned by the mining industry, so they have no influence on this paper at all.

  21. Ken Ward Jr. says:

    AlexM,

    I’m not sure where you got that — read what I wrote:

    “Now, it’s important to note that this paper by Dr. Borak was peer-reviewed, and it’s published in a respected journal. That’s the way science is supposed to work.”

    Ken.

  22. AlexM says:

    Mr. Ward, please see your last paragraph “…it is remarkable to see the coal industry’s hand-picked own consultant publish a paper that raises these issues.” Once again, the mining industry can fund any research they want, however, they cannot influence journal editors or reviewers. Trust me, I have reviewed more than hundred of journal papers and none can have any influence on my assessment of the quality of the papers. In addition, you are aware of ARIES initiative, which is funded by the mining industry, and will engage established researchers, representing an array of disciplines and expertise, from Virginia Tech, West Virginia University, University of Kentucky, Ohio State University, University of Pittsburgh, Pennsylvania State University, and the University of Pennsylvania. I am a very confident that they will submit their findings to the highly recognized refereed journal, and only editors will make decision on acceptance or rejection, based on the reviewers’ recommendation.

  23. Ken Ward Jr. says:

    AlexM,

    That’s exactly my point — Previously, the coal industry’s PR machine put out nasty attacks on the Hendryx papers, and said they had “debunked” his “bogus” work. None of their specific attacks made it into the peer-reviewed paper that was published.

    Two points, here really:

    – It’s true that the NMA doesn’t edit the JOEM. But that doesn’t mean that some researchers funded by one group or another would pick study methods that would be more likely than others to produce particular results. Anybody who doesn’t believe that hasn’t read the book “Doubt is their Product” by Dr. David Michaels, the current chief of OSHA, http://www.defendingscience.org/doubt_is_their_product.cfm .

    That’s why it’s important for us to see what Dr. Hendryx says about the different methods between these two papers.

    – While the NMA picked and paid this particular researcher, I have no doubt that some of what his published paper says isn’t exactly what they would like — Their statements to members and limited press comments on it haven’t included some of the most interesting stuff that’s in there.

    Ken.

  24. AlexM says:

    With all due respect to you Mr. Ward, it appears from your articles that you use every single opportunity to be negative about coal mining in WV. Why not engage in a positive discussion and help the industry apply the latest engineering and scientific discoveries to do a better job. The fact of the matter is that we will depend on coal mining in this great state for a long time, whether we like it or not, so you should help facilitate problem solution, not just hammering the industry every single day. I am not going to justify any PR machine, but you should applaud to an effort of several mining companies to conduct scientific inquiry and research, foster publication and contribute to the relevant literature, and engage in outreach efforts to share and disseminate results through ARIES initiative. Whatever scientific method will be used, it will go through rigorous research scrutiny and peer-review process. I am convinced that the outcome of this research will be a significant help to mining industry in improving their practices and benefiting our great state.

  25. Ken Ward Jr. says:

    AlexM

    Thanks for the continued discussion. As I tell people often, it’s difficult to respond to a broad allegation without specific examples of stories you’re concerned about — things you believe were unfair or inaccurate.

    Regarding the ARIES initiative, reporters and the public are rightly wary of industry-funded “science” — read the book I mentioned above. It’s problematic to hear, as I did at the Coal Symposium, that coal lobbyists were involved in drawing up the plans for ARIES. It’s even more troubling that some of the lead scientists researching these issues weren’t consulted –and that Virginia Tech is talking to industry about its work, but not to citizen groups as well.

    I have not doubt that this research “will be a significant help” to the mining industry. That’s the problem. We need research that will be of a help to the public at large, not just the industry. I am far from convinced that is what ARIES is about, but I’m eager to have them prove me wrong.

    Let me be clear: More research is good. But it needs to be independent, and ARIES doesn’t sound very independent to me. A better way to get more independent research would be to pass an increased coal tax that goes to WVU or Marshall to fund research operations without any input from the industry’s lobby team.

    Ken.

  26. AlexM says:

    So, what any lobbyists have to do with the ARIES research areas: (i) Assessment and mining impacts on ecosystem health and diversity; (ii) Treatment and minimization of constituent discharges; (iii) Accurate prediction of constituent releases by overburden and refuse; (iv) Overburden handling plans and fill designs to minimize releases; (v) Next-generation design of eco-friendly mining systems; and (vi) Evaluating and optimizing the impacts of mining on community well-being. Please look also at the list of the researchers involved in these projects and name the ones who are not experts in these fields. The research that will benefit the mining industry to do a better job will certainly be of a help to the public at large, not just the industry. Unfortunately, ARIES may not sound very independent to you. However, the research integrity and independence are more important than any industrial interests and their research results will be rigorously evaluated in peer-review process.

  27. Ken Ward Jr. says:

    AlexM,

    I’ve looked at the list of researchers. Several of them have very frequently served as paid expert witnesses for the coal industry in quite a number of important cases.

    And we don’t know exactly what involvement industry lobbyists had … At the Coal Symposium the other week, as we reported:

    Jason Bostic, a coal association lobbyist, praised the effort as “one of the most exciting projects I’ve seen” and said he felt “privileged to have been involved in the development of it.”
    http://wvgazette.com/News/MiningtheMountains/201202030121

    The folks who organized this are incredibly tone-deaf, or they don’t believe in being well-rounded. I’m not aware of a single citizen group being asked to either contribute money or to take part in “the development of it” as Jason Bostic claims to have been.

    I’ll be pleased to be proven wrong, but thus far the effort doesn’t seem very independent.

    Ken.

  28. AlexM says:

    Mr Ward,
    Many academics work on industrial, state, and federal funded projects. Those academics who have the PE license are also engaged as expert witnesses. That is not just in mining but in many other industries, and there is nothing wrong with that. What is important here is to look at their peer-review journal publication records. Let them do their job and we will see what the results of their research will be.
    I’ve looked at the publicly available ARIES newsletter at
    http://www.energy.vt.edu/aries/ARIES_Newsletter_1.pdf
    and all these projects appear to be very important.

  29. Ken Ward Jr. says:

    AlexM,

    There may or may not be anything wrong with the arrangement … It really depends. The public doesn’t know enough about how this project was put together.

    One thing Virginia Tech could do to avoid any concerns from the public or the media is to post on its website all communications — emails, project plans, letters, meeting notes — between coal industry funding companies and anyone working on the project. That way, we could all see what input they had. And Virginia Tech could meet with other stakeholders to seek the same level and types of input from them.

    Science doesn’t happen in a vacuum. My friends in the industry like to say, whenever Mike Hendryx’s work comes up, that peer-review isn’t everything … it’s not. It is important, and is a gold standard. But it’s also important to have public transparency.

    Ken.

  30. Ken Ward Jr. says:

    AlexM,

    Your newsletter shows exactly what the problem here is. Look at the title:

    “What the Science Really Shows”

    Inherent in that is the suggestion that the existing science (showing serious water quality impacts, clear air pollution effects on public health, and links to illnesses such as cancer and birth defects) is wrong, and that now ARIES is going to show how and why it’s wrong. Maybe that’s not what the scientists have in mind, but it’s certainly the message any reasonable person not employed by the coal lobby would draw from this.

    Ken.

  31. bugman160 says:

    I found it curioius that the ARIES website links page
    http://www.energy.vt.edu/aries/pageview.asp?pageid=7
    has given top billing to the corporate sponsors and affliates and lists the research institutions second.

    While I am familar with the research of some of the participants listed in the newsletter, I am disappointed that there is such a small pool of available researchers being utilized. If the goal of this project is to produce well rounded science that is beneficial to all, then why are there no researchers listed as collaborators who the industry would consider “green”.

  32. AlexM says:

    Mr. Ward,
    Yes, I would agree with you that some kind of appropriation in the form of coal tax would be very beneficial to do the research at WVU and Marshall. Even a minimal tax at 15 cents per ton of mined coal would provide a significant amount. With an annual coal production in WV of 130 million tons, it would yield $19.5 million in research money. Similar model works quite well in Australia.

  33. AlexM says:

    Bugman160:
    I am not sure if it is a small pool of ARIES researchers or not. How many is enough? In order to do an extensive and thorough research, it must be sufficiently funded. Keeping in mind the current level of funding through the ARIES, adding endless number of researchers may produce nothing. You want to have a focus and plan of accomplishing the goals of the projects. Simple search reveals that ARIS include multi-professional group of researchers in hydrogeology, hydrology, geology, environmental health, public health, medical field, statistics, economy and mining engineering. This is not a simple project of statistical analysis of data stored in governmental database. I am also not quite clear if mining industry knows if these researchers are “blue” democrats, “red” republicans or “green” environmentalists, or none of them. Thanks to Information Technology age, you can simply Google every single ARIES researcher and find out about their research accomplishments through their peer-reviewed publications.

  34. Casey says:

    I guess I agree with AlexM when he writes “that you use every single opportunity to be negative about coal mining in WV”. I realize that you are the chairman of the Society of Environmental Journalists but can’t you ever see and acknowledge anything good about coal? Your attacks on Aries are disappointing for one that espouses the furthering of science.

  35. Ken Ward Jr. says:

    Casey,

    Just to correct you — you don’t seem to actually read things in much detail yet again —

    I am NOT the chairman of the Society of Environmental Journalists. I am the chairman of a work group of that organization, the SEJ First Amendment Task Force.

    You can see a list of SEJ’s elected officers here, http://www.sej.org/about-sej/board-and-staff … I am not one of them. The Task Force chairmanship is an appointed position, and I was chosen for it by our board, mostly because working with and understanding threats to Freedom of Information and the public’s right to know is a bit of a working hobby of mine. The Task Force role is the following:

    — Monitor records access and other right-to-know issues that affect the quality and visibility of environmental journalism.
    — Speak or write to actions that limit access to information and inhibit journalists’ ability to cover the environment and related topics.
    — Provide SEJ members with services to help them obtain and use public records, and to deal with efforts to withhold those records from them.
    http://www.sej.org/initiatives/freedom-information/sej-foi-task-force

    For instance, we have recently been very critical of the Obama administration’s closed-door policies at the U.S. Environmental Protection Agency:

    http://www.sej.org/publications/watchdog-tipsheet/sej-urges-epa-make-science-more-open-news-media

    http://www.sej.org/publications/watchdog-tipsheet/sej-urges-epa-press-office-open-agency-info-news-media

    We also recently objected to the ejection of a journalist from a congressional hearing, http://www.sej.org/publications/watchdog-tipsheet/sej-condemns-house-science-panel-arrest-journalist

    For the record, the mission of the Society of Environmental Journalists is as follows:

    “The mission of the Society of Environmental Journalists is to strengthen the quality, reach and viability of journalism across all media to advance public understanding of environmental issues. ”
    http://www.sej.org/about-sej/vision-and-mission

    Ken.

  36. Casey says:

    Ken, there you go again. Rather than address the intended discussion topic you spin a response to talk about what you want to talk about. Okay rather than stating that you are “the chairman” I should have stated “a chairperson” perhaps. Regardless it seems some times when points are raised on this site, you have a tendency to label them as straw men or ignore them and proceed with your own topic points. When you do that I feel like you are really close minded. Just me I guess.

  37. Casey says:

    Furthermore, I have spent my professional life recognizing problems then proposing and implementing solutions. You recognize a lot of problems with coal (and it seems little if any benefits). The last problem you recognized is that health problems are caused from social problems which are largely caused from the natural resource extraction of coal. If this is not exactly accurate please correct. Then I am interested in your proposed solution to this problem.

  38. Ken Ward Jr. says:

    Casey,

    First, just to address your point about the Society of Environmental Journalists reference.

    I have no idea where you got this notion about “chairman” versus “a chairperson.” You wrote:

    “I realize that you are the chairman of the Society of Environmental Journalists but can’t you ever see and acknowledge anything good about coal?”

    You’re suggesting that I’m in charge of SEJ and that this somehow means my coverage is somehow inaccurate or unfair. I just wanted to point out, for the sake of truth and facts, that I’m not an elected official of that group. I’m just a volunteer chairman of a working group that seeks to advance the public’s right to know about all matter of environmental issues. And furthermore, there’s nothing at all about SEJ’s mission that suggests that the organization somehow encourages inaccurate or unfair coverage of any environmental issue. That’s all.

    And let’s just go back and review the comments you’ve made thus far and my responses, so everyone can be clear on what sort of discussion you’re trying to have …

    — First, in response to the blog post I wrote, you posted the following comment:

    “Ken, You stated that various groups “have been sometimes over the top in their description of what Dr. Michael Hendryx has found”. Maybe those groups include you when you repeatedly use the phrase “the growing science that links living near mountaintop removal mining to being at greater risk of cancer or birth defects” or the “growing body of evidence”.
    Borak said about Hendyrx “If he wants to say it’s coal mining, he can say that, but I’m not sure he’s correct”. There are a lot of social problems related to health in West Virginia that need addressed. I do not think using these problems as any opportunity to attack coal, that provides so much opportunity for many families, is proper, prudent or helpful but is indeed the opposite of those things.”

    I responded by explaining the initial findings of the first of the Hendryx papers, and outlining how additional work, with various co-authors from various institutions, has continued and explained:

    “Any reasonable person would agree that 20 papers published over a five-year period by Dr. Hendryx and a variety of other co-authors at other institutions in major peer-reviewed journals constitutes a growing body of science … each new study adds to the knowledge base, providing a “growing body of evidence” on the topic.”

    While you wrote, apparently aimed at me:
    “There are a lot of social problems related to health in West Virginia that need addressed. I do not think using these problems as any opportunity to attack coal, that provides so much opportunity for many families, is proper, prudent or helpful but is indeed the opposite of those things.”

    But, as I explained in response, it was not me — but the NMA’s paid consultant, Dr. Borak — who raised the notion that coal may indeed play a role in causing these problems:

    ” ” … The possibility that mining contributes to the development of the social environments and cultural practices that adversely impact health … seems most likely in those specific areas where mining is the principal industry””
    What does this mean? Well, you wrote about mining providing “so much opportunity for many families,” but Borak and his authors are cautioning that coal might actually be contributing to the very social problems that you claim to be concerned about. This paper if far from a clear-cut “debunking” of Dr. Hendryx and is well worth giving a look. It will be especially interesting to see what sort of response Dr. Hendryx provides to the JOEM … that’s the way science is supposed to work.”

    Any reasonable person who actually wants to discuss these issues, and not just defend the coal industry, would easily — very easily — see that I’ve responded directly to the points you raised, your criticisms of what I wrote, and the question you asked.

    But this is where the discussion went off the rails, and where you decided that, rather than talk about the Borak paper, you would raise the straw man argument of eliminating all coal mining — a proposal that was not suggested in any way in the blog post I wrote (or in the Borak paper). You wrote:

    “Ken writes ”but Borak and his authors are cautioning that coal might actually be contributing to the very social problems that you claim to be concerned about.” Please explain how that “might” work exactly.
    Anyway so coal might be causing social problems therefore let’s stop mining. Is that the conclusion?
    What sort of social problems do you think would result if coal mining was stopped in Southern WV? How do you think massive unemployment and loss of tax base would affect the issues that Borak wrote about like “greater economic distress, lesser educational attainment, decreased access to health care, limited availability of nutritious foods, higher rates of behavior-related risks such as obesity and smoking, and decreased use of preventive health services”?
    A growing body of non-government entities that thrive and provide economic benefits and jobs are the best medicine for what ails the coal fields.”

    I responded, in part:

    “Regarding your latest comment, it’s difficult to have much of a discussion with you when your so quickly revert to throwing up straw-men arguments about stopping all coal mining, instead of focusing on the paper we’re discussing and what it actually says.”

    I continued to try to discuss the Borak paper, quoting from it and other published literature, trying to steer Coal Tattoo’s discussion toward answering the question you asked (To quote you: “Ken writes ”but Borak and his authors are cautioning that coal might actually be contributing to the very social problems that you claim to be concerned about.” Please explain how that “might” work exactly. “). For example, I wrote, in response to your question about how that “might” work exactly:

    How does mining perhaps contribute to the development of the social environments and cultural practices that adversely impact health?

    “Well, this isn’t exactly a new idea … Some scholars have offered “the resource curse” as an explanation (see some basic discussion of this here (http://en.wikipedia.org/wiki/Resource_curse ). It’s simply the notion that being rich in natural resources like coal, natural gas and timber has made us dependent on those resources, and allowed us to avoid having to do the harder work of diversifying our economy, improving our educational system, and otherwise doing the things that might make Appalachia more healthy, successful and rich, in money and in so many other things.”

    Your response to my efforts at this reasonable discussion? Here’s what you wrote:

    “I guess I agree with AlexM when he writes “that you use every single opportunity to be negative about coal mining in WV”. I realize that you are the chairman of the Society of Environmental Journalists but can’t you ever see and acknowledge anything good about coal? ”

    Come now … as I wrote before, the troubling thing here for the coal industry and coal industry folks like yourself is that Borak’s paper is a far more subtle product that the NMA certainly had to hope it would be. The conclusions and discussion from the authors doesn’t lend itself to the sort of PR stunts that the NMA and its agents have tried before to use to discredit science. Thus, when confronted with it, you go from misquoting what it says (because you relied on Bruce Watzman’s summary) very quickly to a personal attack on my membership in a professional organization for journalists.

    I’d encourage you to go back and actually read the Borak study, and come back to this blog with the notion that actually discussing what it says it what the comments section on this post is for.

    In the meantime, I’ll try to answer the only unanswered question you’ve posed to me … you wrote:

    “… But can’t you ever see and acknowledge anything good about coal?”

    OK … just to review a few blog posts from Coal Tattoo’s past, starting with our very first post:

    “Coal helped to build industrial America, powered our nation through two world wars, and is still an important part of the economy in coalfield communities from West Virginia to Wyoming. And, as industry supporters and their billboards remind us, coal keeps the lights on in about half of all American households.”
    http://blogs.wvgazette.com/coaltattoo/2009/02/05/welcome-to-coal-tattoo/

    Or a recent post quoting extensively from Alpha CEO Kevin Crutchfield about the importance of coal to society, http://blogs.wvgazette.com/coaltattoo/2011/09/01/alpha-ceo-coal-the-goose-that-laid-the-golden-egg/

    Or this story, about a major coal-fired utility supporting climate change legislation, and saying that global warming is a challenge the industry can handle? http://blogs.wvgazette.com/coaltattoo/2010/08/04/coal-burner-appalachian-power-disappointed-by-senate-inaction-on-u-s-climate-change-bill/

    Or the portions of this story that clearly point out coal’s importance to the state economy:

    “Coal plays a significant role in West Virginia’s economy, contributing hundreds of millions of dollars in state and local revenue and providing well-paying jobs to tens of thousands of West Virginians.”
    http://blogs.wvgazette.com/coaltattoo/2010/06/22/must-read-report-coal-industry-costs-w-va-state-budget-97-5-million-a-year-more-than-it-generates/

    Or gosh, this almost gushing account of CONSOL Energy’s new “green” headquarters:
    http://blogs.wvgazette.com/coaltattoo/2010/02/26/consol-goes-green-with-new-headquarters/

    Can’t I ever see and acknowledge anything good about coal? This blog and the newspaper I work for do it all the time … the problem is that people in the coal industry — like most businesses — don’t want their negatives reported. That’s just human nature.

    Thanks everybody for the discussion … I’m going to let Casey get in one more shot here and have the last word, and then we can move on. Ken.

  39. Casey says:

    Thanks for the last shot. I’m not sure where I requested an incorrigible Ken Ward recap in my last post but that’s what I got. I think what I did ask from you was a proposed solution when I stated “The last problem you recognized is that health problems are caused from social problems which are largely caused from the natural resource extraction of coal. If this is not exactly accurate please correct. Then I am interested in your proposed solution to this problem.”

    This was to give you an opportunity to be part of the solution rather than part of the problem. It is easy to recognize problems and it is easy to point out problems with proposed solutions. I’m interested in your solutions and in particular a solution to this particular problem that you have recognized as part of this blog’s topic. I know you want to move on but I really hoped you would respond to this direct request. Thanks.

  40. Ken Ward Jr. says:

    Casey,

    Since you asked … I’ll go ahead and try to again answer your question … any reasonable reader of this blog would certainly know of a variety of possible solutions that I’ve found interesting and therefore written about.

    One is the notion of an additional tax on coal and natural gas to fund a long-term economic development, education and infrastructure fund. We’ve written about that here, http://blogs.wvgazette.com/coaltattoo/2012/01/31/will-w-va-prepare-for-a-post-coal-future/

    Another is to stop sending so much AML money to states that have already certified they cleaned up all of their old abandoned coal mines … We’ve written about that here, http://wvgazette.com/News/MiningtheMountains/201202140119

    The industry’s own consultant, Dr. Borak, had this to say about solutions to these problems:

    “To the extent that coal mining is factor in defining the cultural fabric and socioeconomic environment of Appalachian communities, the coal-mining industry must play a role in efforts to increase economic diversity, develop job-creation programs, ensure access to appropriate heath care services, improve educational opportunities, and facilitate access to nutritious foods and diets.”

    Dr. Hendryx has himself outlined some interesting thoughts on these issues here, http://thesolutionsjournal.org/node/708 and here, http://appalachiantransition.net/sites/ati/files/essays/Hendryx%20essay.pdf

    But of course, the first step toward fixing any problem is to truly understand that problem and confront its root cases. I’m not sure we’re there yet.

    Ken.

  41. Barbara Rasmussen says:

    Ken:

    This Yale study really concerns me because it once again raises
    > the specter of culture bashing and victim blaming with all of its “suggestions” that cultural practices may be involved in these health questions.
    > I think this lso sounds culturally imperial. I would hope for more
    > from an Ivy League research team. Similar assertions and innuendos
    > were the same things used in the 1920s to ride roughshod over the southern Appalachian
    > land owners and the local culture. The observation then was “these people
    > need to be educated or annihilated.” I hope there’s been some enlightenment since then.

    Barbara Rasmussen

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