The Relationship between Mountaintop Coal Removal and Adolescent and Young Adult Risk Behaviors in Rural, Urban, and Appalachian Areas of Kentucky

In Appalachia, coal mining remains a major source of industry, yet it is associated with significant environmental and health consequences, including increases in rates of depression, cancer, cardiac and respiratory diseases, birth defects, low birth weight, stress, and overall poor physical health. There is a dearth of research on the effect of mountaintop coal removal (MTR) mining on Appalachian mental health. In the current study, a statewide emergency department dataset (SEDD) was used to compare, adolescents and emerging adult cases. It was hypothesized that both location in Appalachia and the presence of MTR would be associated with higher odds of risky behaviors (e.g. self-harm, substance use, and sexually transmitted infections). Cases from SEDD were separated in to groups from rural and non-rural, Appalachian and non-Appalachian, with and without MTR. These groups were compared through a series of binary logistic regressions. Adolescents and emerging adult ins Appalachia, rural Appalachia, and rural Appalachia with MTR had relatively higher odds of diagnosis of polysubstance use disorder. Cases experienced increased odds of diagnosis with an alcohol use disorder in rural Appalachia with and without MTR. This suggests that MTR may play an influencing role in rural Appalachian substance use.