The authors show that residents of coal mining counties both inside and outside of Appalachia had fewer healthy days for both physical and mental reasons. The disparities were greatest for people residing in Appalachian coal mining areas. The authors conclude that residents living in coal mining areas are “characterized by greater socioeconomic disadvantage, riskier health behaviors, and environmental degradation” which are all associated with a lower health-related quality of life.
Zullig, K., and M. Hendryx. (2010) “A Comparative Analysis of Health-Related Quality of Life for Residents of U.S.Counties with and without Coal Mining.” Public Health Reports, Volume 125