Department of Health Policy, Management and Leadership, School of Public Health, West Virginia University, Morgantown, WV 26506, USA.
J Rural Health. 2013 Aug;29 Suppl 1:s79-88. doi: 10.1111/jrh.12016. Epub 2013 Mar 12.
This study investigates health disparities for adults residing in a mountaintop coal mining area of Appalachian Kentucky. Mountaintop mining areas are characterized by severe economic disadvantage and by mining-related environmental hazards.
A community-based participatory research study was implemented to collect information from residents on health conditions and symptoms for themselves and other household members in a rural mountaintop mining area compared to a rural nonmining area of eastern Kentucky. A door-to-door health interview collected data from 952 adults. Data were analyzed using prevalence rate ratio models.
Adjusting for covariates, significantly poorer health conditions were observed in the mountaintop mining community on: self-rated health status, illness symptoms across multiple organ systems, lifetime and current asthma, chronic obstructive pulmonary disease, and hypertension. Respondents in mountaintop mining communities were also significantly more likely to report that household members had experienced serious illness, or had died from cancer in the past 5 years. Significant differences were not observed for self-reported cancer, angina, or stroke, although differences in cardiovascular symptoms and household cancer were reported.
Efforts to reduce longstanding health problems in Appalachia must focus on mountaintop mining portions of the region, and should seek to eliminate socioeconomic and environmental disparities.
本研究调查了居住在肯塔基州阿巴拉契亚山区山顶煤矿区的成年人的健康差距。山顶矿区的特点是严重的经济劣势和与采矿相关的环境危害。
实施了一项以社区为基础的参与式研究，以收集来自居民的信息，比较肯塔基州东部的农村山顶矿区和农村非矿区居民的自身和其他家庭成员的健康状况和症状。通过挨家挨户的健康访谈，从 952 名成年人那里收集了数据。使用患病率比模型分析数据。
在调整了协变量后，山顶矿区的健康状况明显较差，表现在：自我评估的健康状况、多个器官系统的疾病症状、终身和当前的哮喘、慢性阻塞性肺疾病和高血压。山顶矿区的受访者也更有可能报告说，家庭成员在过去 5 年内患有严重疾病或因癌症去世。虽然报告了心血管症状和家庭癌症方面的差异，但自我报告的癌症、心绞痛或中风方面没有观察到显著差异。
要减少阿巴拉契亚地区长期存在的健康问题，必须集中精力解决该地区的山顶矿区问题，并应努力消除社会经济和环境方面的差距。
