OBJECTIVE: Determine whether select cause of death mortality disparities in four Appalachian regions is associated with coal mining or other factors.
METHODS: We calculated direct age-adjusted mortality rates and associated 95% confidence intervals by sex and study group for each cause of death over 5-year time periods from 1960 to 2009 and compared mean demographic and socioeconomic values between study groups via two-sample t tests.
RESULTS: Compared with non-coal-mining areas, we found higher rates of poverty in West Virginia and Virginia (VA) coal counties. All-cause mortality rates for males and females were higher in coal counties across all time periods. Virginia coal counties had statistically significant excesses for many causes of death.
CONCLUSIONS: We found elevated mortality and poverty rates in coal-mining compared with non-coal-mining areas of West Virginia and VA. Future research should examine these findings in more detail at the individual level.

Woolley et al. 2015a

Risk of bias

Epidemiological study populations

HAWC