Date of Graduation


Document Type


Degree Type



School of Public Health


Health Policy, Management & Leadership

Committee Chair

Michael McCawley

Committee Co-Chair

Lowell Duckert

Committee Member

Thomas O Patrick

Committee Member

Kimberly Rauscher

Committee Member

David S Simonton


The coalfields region of central Appalachia bears the unfortunate hallmark characteristics of low socioeconomic status, poor health outcomes, and some of the lowest life expectancies in the United States, making some residents potentially part of vulnerable health populations. Vulnerability impacts the ability of individuals to respond or recover from stressors--- particularly environmental pollution---not as well as other individuals. Moreover, the economic outlook for the region is grim, given that the international coal mining industry has experienced serious recent downturns, and increased production from the natural gas sector has made coalfired power production domestically less competitive. As a result, many of the larger coal companies are in or have recently been in bankruptcy, leaving coal mining states at risk for large-scale forfeitures and abandoned coal mines. In 2016, the West Virginia Department of Environmental Protection (WVDEP) estimated that coal operators in the bankruptcy process held over 900 mine site permits, leaving sites in various stages of mining. Unremediated coal mines may pose a risk for safety and discharge pollutants into surface waters, potentially impacting water quality. Given that the communities near coal mines may constitute vulnerable health populations, the impacts of pollution stressors pose a serious public health concern. Coal mining states should prioritize the remediation of forfeited and abandoned coal mines due to these concerns. However, serious financial limitations may impact the states' abilities to remediate these sites.;Under the Surface Mining Control and Reclamation Act (SMCRA), coal mine operators are required to post full financial assurance that the mine site will be remediated to environmental performance standards. If a coal mine operator abandons a site without fully remediating the environmental impacts, the state becomes responsible for the reclamation. However, due to the ways states administer the bond programs under SMCRA, they may have limited financial and administrative resources to remediate all existing abandoned coal mines, and the possibility of future abandoned sites may strain those resources further. These issues of available remediation resources is compounded by the disparate impacts of coal mining between the counties, as well the watersheds. In West Virginia, disparities exists between the counties for the amount of acres impacted by coal mining, with higher levels of mined acres occurring in counties with the poorest health rankings. In addition, some counties and watersheds are much more impacted by the costs of under-secured reclamation bonding. Counties with the worst health outcome rankings have the greatest amounts of potential risks for under-secured coal mine bonding. As a result, vulnerable health populations may live in areas where the state does not have adequate financial assurance to remediate abandoned coal mines and the watersheds heavily impacted by mining, placing these residents at further risk for long-term environmental stressors.;Surface water pollution presents one source of environmental stressor. Long-term surface water quality issues may already exist at many coal mine sites, as evidenced by a history of longterm pollutant discharge violations under the Clean Water Act (CWA). Over 43% of the individual coal mine sites that West Virginia Department of Environmental Protection (WVDEP) certified would meet water quality standards and nearly half of the total WVDEP coal mining state water quality certifications issued in order for the sites (or portions of the sites) to be constructed under the CWA resulted in consent decrees or other types of settlements for violations of state water quality standards. These pollutant discharge violations were also from larger acre sites with that predominantly drain into the Coal, Upper Guyandotte, Upper Kanawha, Lower Guyandotte, and other watersheds that are currently listed with impaired status under the CWA. CWA violation consent decrees involving 5 of the largest coal operators in West Virginia occurred in areas of the state with the worst health rankings.;With limited financial and administrative resources, WVDEP is currently responsible for remediation at 192 post-SMCRA forfeited mines with water pollution discharges, at an estimated initial cost of {dollar}35.5 million and {dollar}6.7 million in annual treatment costs. WVDEP has not completed remediation at these sites. Because of the need for prioritization of the state's cleanup of these forfeited mines, regulations require that WVDEP maintain a priority listing of forfeited sites based upon (1) the severity of the water discharges, (2) the quality of the receiving stream, (3) the effects on downstream water users, and (4) "other factors" determined to affect the priority ranking. Surface coal mine remediation presents an excellent opportunity to improve both the environment of the coalfields and the health in communities surrounded by coal mines and downstream of polluted mining water discharges. By utilizing a community health impacts assessment conceptual model tailored to the concerns of West Virginia and central Appalachia, WVDEP can identify the existing pollution burdens on communities and vulnerable health populations to utilize community health as one factor in prioritizing mine remediation. By utilizing data that the state---specifically WVDEP---already collects and maintains, as well as other easily-accessible and publicly available information, WVDEP can utilize this community health assessment conceptual model framework to objectively consider characteristics of the coalfield communities. This conceptual model is objective and tailored to mine remediation. It fits within existing West Virginia laws and regulations and would not require Legislative rulemaking to incorporate into practice.