SOCIO DEMOGRAPHIC AND PERSONAL RISK DETERMINANTS OF CARDIOVASCULAR AND CIRCULATORY HOSPITALIZATION RATES IN COAL MINING AND NON COAL MINING COMMUNITIES IN WEST VIRGINIA

Working in a coal mine has long been known as a hazardous occupation, with potential for occupational noise exposure, injuries, and respiratory disease due to exposure to coal dust resulting in black lung or pneumoconiosis. More recently, living near coal mines has been reported to adversely affect the health of residents.

According to America’s Health Rankings, WV ranks between first and third worst for hypertension, diabetes, smoking and obesity. All West Virginia hospitalizations from 2005 through 2009 were obtained from the West Virginia Health Care Authority (n=1,236,841). The total counts (for all five years) of circulatory outcomes (ICD-9 codes 390 - 459) and respiratory outcomes (ICD-9 codes 460 - 519) per county were tallied by gender and age group. Age adjusted hospitalization rates were calculated.

Census data including urban/rural designation, percent minority, poverty, and educational attainment was collected at the county level. Behavioral Risk Factor Surveillance System data was also obtained for each county in West Virginia, and includes obesity and smoking rates. Coal production rates were gathered from the 2005 WV Office of Miners’ Safety and Training (http://www.wvminesafety.org/cnty2005.htm) report. The number of residents who work in the coal mining industry was provided by this report, and is only available for counties that mine coal, although it is reasonable to assume that there are employees of coal mines who reside in non-coal mining counties.

Using spatial regression, which accounts for spatially close neighbors having similar sociodemographic characteristics, surface coal mined within a county had a significant association with all circulatory, all respiratory, female circulatory, female respiratory, male circulatory, and male respiratory age adjusted hospitalization rates after adjusting for poverty, smoking, and proportion of the county in the coal industry. Poverty and smoking also predicted hospitalization outcomes. Underground mining was associated with all circulatory, male circulatory and female circulatory hospitalization rates after adjustment for sociodemographic characteristics. Underground mining was not related to respiratory hospitalization rates after adjustment for smoking or educational attainment.