Abstract
Background: Earlier examinations of mortality patterns in West Virginia found higher total mortality in coal mining compared to non-coal mining counties. The objective is to further explore these findings and determine whether heart disease mortality in West Virginia is associated with coal mining or other factors.
Methods: West Virginia county Specific Standardized Mortality Ratios (SMRs) were calculated and base (sex, age group and time period-adjusted) and covariate-adjusted (base + income, smoking, and obesity) SMR models were computed for cumulative total, surface, and underground coal production. Models were also stratified by dichotomous versions of income, smoking, and obesity.
Results: Median income, obesity, and smoking were all found to be statistically significant predictors of heart disease SMRs and were also found to have statistically significant interactions with coal production. Specifically, SMRs generally increased as median income decreased in mining counties, and SMRs generally increased as obesity increased in mining counties. The same relationships were not evident in non-mining counties. Additionally, SMRs were elevated in the highest two quartiles of coal production in counties with high smoking prevalence.
Conclusion: SMRs for heart disease were elevated in the highest levels of total, surface and underground coal production compared to the state population. Further research should examine the relationship between coal-mining and heart disease at the individual level.
Citation
Balmert L, Youk AO, Woolley S, Talbott EO and Buchanich JM. Heart Disease Mortality in Appalachian Coal Mining Counties. SM J Public Health Epidemiol. 2015; 1(1): 1002.