Health-Related Quality of Life Among Central Appalachian Residents in Mountaintop Mining Counties

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Abstract
Objectives. We examined the health-related quality of life of residents in mountaintop mining counties of Appalachia using the 2006 national Behavioral Risk Factor Surveillance System. Methods. Dependent variables included self-rated health; the number of poor physical, poor mental, and activity limitation days (in the past 30 days); and the Healthy Days Index. Independent variables included metropolitan status, primary care physician supply, and Behavioral Risk Factor Surveillance System behavioral and demographic variables. We compared dependent variables across 3 categories: mountaintop mining (yes or no), other coal mining (yes or no), and a referent nonmining group. We used SUDAAN MULTILOG and multiple linear regression models with post hoc least squares means to test mountaintop mining effects after adjusting for covariates. Results. Residents of mountaintop mining counties reported significantly more days of poor physical, mental, and activity limitation and poorer self-rated health (P < .01) compared with the other county groupings. Results were generally consistent in separate analyses by gender and age. Conclusions. Mountaintop mining areas are associated with the greatest reductions in health-related quality of life even when compared with counties with other forms of coal mining.