Mode of Program Participation
Academic Scholarship
Participation Type
Panel
Session Title
Chronic Disease in Appalachia
Presentation #1 Title
Social Determinants of Health Effecting Chronic Health Mortality and Death Due to Injury in Virginia Coal Counties
Presentation #1 Abstract or Summary
Recent publications have associated the environmental impacts of mountain top coal mining in Appalachia with increased prevalence of chronic conditions such as obesity, diabetes mellitus, heart diseases, cancers, and kidney diseases as well as deaths due to injury. Our previous review and subsequent study findings on chronic health conditions in coal communities in Central Appalachia indicated regional differences in lifestyle behaviors and sociodemographic factors. Programs targeting specific geographic areas can benefit using evidence based knowledge to implement interventions with measureable goals to reduce localized and persistent rates of chronic diseases. The objective of this cross-sectional study was to identify distinguishing social determinants of health affecting chronic health conditions in coal producing counties in Virginia (VA). Sociodemographic data on various factors were obtained from County Health Rankings (2015) for the year 2012 for coal producing counties in VA. An analysis of external causes of death served as a control for chronic health conditions. Differences in VA county averages for coal production, chronic health conditions, population, income, unemployment, poverty, persons over age 65, rurality, annual health care costs, and smoking were reported. In conclusion, health disparities continue to persist in coal production counties. Two factors identified were unemployment and smoking cessation as the most likely factors to include in future intervention programs to benefit health in coal counties in VA. Education with a focus on health literacy was also identified as a factor to address to improve health in VA coal communities. Our findings add support for multidisciplinary health care teams to engage local residents in prevention and self-managed care in communities with persistent health disparities.
Funding source: This study was sponsored by the Appalachian Research Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at http://www.energy.vt.edu/ARIES.
Co-authored by Susan Meacham, Dalia Meisha, Cody Goessl.
Presented by Meacham and Goessl
At-A-Glance Bio- Presenter #1
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Presentation #2 Title
CANCER DEATH RATES IN COAL PRODUCTION COUNTIES IN SOUTHWEST VIRGINIA EVALUATED ON COUNTY AND INDIVIDUAL LEVELS
Presentation #2 Abstract or Summary
The health disparities in Central Appalachian have persisted over time at elevated rates compared to other regions. Since 1990 rates of cancer deaths have improved, yet declines were better in men than in women and better in comparison counties than in counties in southwest Virginia (VA). Previous reports have implicated coal production as the primary causal factor in elevated chronic health conditions. Counties in southwestern VA that produce coal have not met Healthy People 2020 lifestyle goals associated with improvements in cancers like other counties in VA. However, the majority of individuals with the most direct environmental contact with coal production are miners, mostly men. The primary objective of this study was to provide descriptive data on cancer and lung cancer death trends in coal production counties in VA from two data sources 1) longitudinal data aggregated by county over 50 years and 2) from individual medical record diagnoses from hospital admissions in 2012. An IRB approved protocol allowed obtaining Virginia Department of Health mortality records (n=755,414) for the years 1960-2012 (n=5,213). Data extracted for each county in two health districts in southwest VA were reported for years 2000-2010 and descriptive statistics provided for age, gender, education, place of residence and place of death. Data extracted from individual electronic medical records (EMR) were obtained from participating hospital admissions for the year 2012. Preliminary findings (n=878) were reported in coal miners and those with other occupations, confirming cancer diagnosis by International Classification of Diseases (ICD) codes, clinical and laboratory tests and physician’s notes For EMR preliminary data by occupation was used to categorize highest coal exposure individuals, 155 were coal miners, 351 had other occupations and for 372 information was not reported or missing, thus, excluded from further analysis. Cancers, particularly lung cancers, remain a health concern in coal dependent communities. However, the highest rates were in women (VDH data) and no differences were detected by occupation between coal miners and other occupations (EMR data) contradicting popular beliefs and previous reports associating coal mining with higher rates of cancers. Funding source: This study is sponsored by Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at http://www.energy.vt.edu/ARIES.”
Co-authors:
C. L. Goessl, Ph.D. Candidate, Department of Health Promotion, Social & Behavioral Health University of Nebraska Medical Center, Omaha, Nebraska
S. L. Meacham, Ph.D., R.D., Professor, Via College of Osteopathic Medicine – Virginia Campus
Presentation #3 Title
Challenges in Separating Out Health Effects of Different Factors in a Non-experimental Setting: Some preliminary Results of Coal Mining and other Factors in Southwest VA.
Presentation #3 Abstract or Summary
Health disparities and poverty in Central Appalachia have persisted for decades. Coal mining, the industry that has historically provided the economic base for the region, has recently taken a downward turn in production. To date, no peer-reviewed publications have investigated the differential impacts of coal mining, poverty, and access to health care simultaneously on various health outcomes in southwest Virginia (VA). In our prior study, data on coal production, poverty, children in poverty and unemployment were compared in regions of within southwest VA. The earlier findings did not identify clear relationships in southwestern VA counties relating economic factors to changes in coal production from 1990 to 2012. This subsequent study addresses a broader geographic area and includes more health factors to gain a better understanding of the impact of fluctuating coal production, economic variables, and health access variables in coal mining regions. In the current study modeling strategies using individual and county level data will help identify differentiating factors in coal and non-coal regions of Virginia from 1999 to 2012. The counties in the southwestern region of Virginia are being compared to counties in Southside VA and eastern VA. Health outcome considered include various chronic conditions such as heart disease, lung diseases and various cancers as well as deaths due to injury. The expected outcomes will help Virginia focus on policies and intervention programs addressing targeted economic and health variables, particularly in coal producing regions of the state. Funding source: This study was sponsored by the Appalachian Research Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at http://www.energy.vt.edu/ARIES.
Co-authors: Meacham, Ruodin, Ruth, Goessl.
Social Determinants of Health Effecting Chronic Health Mortality and Death Due to Injury in Virginia Coal Counties
Recent publications have associated the environmental impacts of mountain top coal mining in Appalachia with increased prevalence of chronic conditions such as obesity, diabetes mellitus, heart diseases, cancers, and kidney diseases as well as deaths due to injury. Our previous review and subsequent study findings on chronic health conditions in coal communities in Central Appalachia indicated regional differences in lifestyle behaviors and sociodemographic factors. Programs targeting specific geographic areas can benefit using evidence based knowledge to implement interventions with measureable goals to reduce localized and persistent rates of chronic diseases. The objective of this cross-sectional study was to identify distinguishing social determinants of health affecting chronic health conditions in coal producing counties in Virginia (VA). Sociodemographic data on various factors were obtained from County Health Rankings (2015) for the year 2012 for coal producing counties in VA. An analysis of external causes of death served as a control for chronic health conditions. Differences in VA county averages for coal production, chronic health conditions, population, income, unemployment, poverty, persons over age 65, rurality, annual health care costs, and smoking were reported. In conclusion, health disparities continue to persist in coal production counties. Two factors identified were unemployment and smoking cessation as the most likely factors to include in future intervention programs to benefit health in coal counties in VA. Education with a focus on health literacy was also identified as a factor to address to improve health in VA coal communities. Our findings add support for multidisciplinary health care teams to engage local residents in prevention and self-managed care in communities with persistent health disparities.
Funding source: This study was sponsored by the Appalachian Research Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at http://www.energy.vt.edu/ARIES.
Co-authored by Susan Meacham, Dalia Meisha, Cody Goessl.
Presented by Meacham and Goessl
