Unintended consequences of the Clean Air Act: Mortality rates in Appalachian coal mining communities |
| |
| Institution: | 1. Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN 47505, USA;2. Department of Environmental Health, School of Public Health, Indiana University, Bloomington, IN 47505, USA;1. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia;2. IMPACT SRC, School of Medicine, Faculty of Health, Deakin University, 1 Gheringhap Street Geelong, Victoria, 3220, Australia;3. School of Natural Sciences, University of Tasmania, Sandy Bay Campus, Churchill Ave, Hobart, Tasmania, 7001, Australia;4. Monash Rural Health – Churchill, Monash University, Northways Rd, Churchill, Victoria, 3842, Australia;5. Menzies Institute of Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia;6. Centre for Traumatic Stress Studies, The University of Adelaide, Level 1, Helen Mayo North, 30 Frome Road, South Australia, 5005, Australia;7. Ambulance Victoria, 375 Manningham Road, Doncaster, Victoria, 3108, Australia;1. Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois;2. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama;3. Department of Healthcare Organization and Policy, University of Alabama at Birmingham, Birmingham, Alabama;4. Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, Alabama;1. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina;2. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina;3. Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington;4. Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs (VA) Healthcare System, Durham, North Carolina;5. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina;6. Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland;7. Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina |
| |
| Abstract: | The 1990 amendments to the US Clean Air Act (CAA) encouraged the growth of mountaintop removal (MTR) coal mining in Central Appalachia. This study tests the hypothesis that the amendments had unintended impacts on increasing mortality rates for populations living in these mining areas. We used a panel design to examine adjusted mortality rates for three groups (all-cause, respiratory cancer, and non-cancer respiratory disease) between 1968 and 2014 in 404 counties stratified by MTR and Appalachian/non-Appalachian status. The results showed significant interactions between MTR status and post-CAA period for all three mortality groups. These differences persisted after control for time, age, smoking rates, poverty, obesity, and physician supply. The MTR region in the post-CAA years experienced an excess of approximately 1200 adjusted deaths per year. Although the CAA has benefits, energy policies have in general focused on the combustion portion of the fossil fuel cycle. Other components of fossil fuel production (e.g. extraction, transport, and processing) should be considered in the comprehensive development of sustainable energy policy. |
| |
| Keywords: | Mountaintop removal Clean Air Act Unintended consequences Mortality Appalachia |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
