Mountaintop Removal Coal Mining and Emergent Cases of Psychological Disorder in Kentucky.

Although mountaintop removal (MTR) coal extraction techniques have been employed in Appalachia for decades, relatively little research has examined its potential psychological impact on people living in close proximity to MTR activity. The current study taps the State Emergency Department Database (Healthcare Cost and Utilization Project, Kentucky State Emergency Department Database, 2008) to examine the relative risk for diagnoses of depressive, substance use, and anxiety disorders originating in areas with and without MTR activity. Logistical regression analyses, controlling for ethnicity, rurality, mean income, and gender, indicated that MTR independently predicts greater risk for depressive (OR 1.37) and substance use disorders (OR 1.41), but not anxiety disorders. Overall, these findings have public health policy implications, build on other evidence of increased risk of negative mental health outcomes related to MTR, and lend some support to the validity of solastalgia related to environmental change.