The Health Burden of People Affected by Extractive Industries

Extractive industries have scarred Appalachia, leaving the area without a livable standard of living, healthcare, or alternative and sustainable industries (Britton-Purdy in The Atlantic, 2016 [1]). According to data collected from 1990 through 2013, infant mortality was 16% higher inside Appalachia as opposed to the United States (Singh et al. in Health Aff 36:1423–1432, 2017 [2]). These statistics also may mirror rural America. Wide health disparities are accentuated with the white poor and even more in people of color in high poverty areas of Appalachia. Additionally, compared to the rest of the country, the Appalachian region has higher mortality with multiple diseases, injuries, suicide, and drug overdose (Singh et al. in Health Aff 36:1423–1432, 2017; Moody et al. in Rural Mental Health 41:123–135, 2017; Wilson et al. in Cancer Epidemiol Biomark Prev 25:250–258, 2016 [2–4]). Appalachia can build back better in an environment where physical and mental health can be promoted as a model for all rural America. Poverty affects health, but ignoring the environment increases health risks as well. Even with economic development, it is the people, the workers, who can and will make an economy happen. Because of this, the purpose of this paper is to make a case for placing health policy at the front end of any economic development initiative. Health and environmental professionals see things more broadly for the road ahead, and the consequences that may occur if health and human service policies are forgotten in the rush to create jobs. Healthcare workers see the results of environmental negligence from the extractive industries with illness, long term injuries, infant mortality, and drug use. This paper was written with an occupational and environmental nursing perspective to describe the health issues of three unique groups affected by the disparities seen in Appalachia. A broad assessment and possible solutions will be forwarded revolving around three groups: the worker, the women, and children.