Coal Mines and Multi-Faceted Risks in the United States: On a Path Toward a Sustainable Future or Emptying Out?

Coal is a major source of fuel in many countries, but its mining and use increase the impacts on human and environmental health. Given the wide variation in coal use by nation, we focused on one—the United States. Specifically, we examined the public health, community, and demographic characteristics of 130 U.S. counties with underground and/or surface coal mines that exemplify a land use that leads to a combination of natural and anthropogenic risks. We compared these 130 to other U.S. counties, finding that the coal counties had poorer health outcomes and behaviors, fewer community assets, lower socioeconomic status, and higher population losses compared to the remaining counties in their host states and other U.S. counties. Next, we looked for differences within the 130 coal counties. Counties with the most coal mines and production had the worst outcomes, especially when located in rural areas. We then examined federal programs to assist these coal communities, observing that the largest federal government programs appear to be sending more resources to the most distressed coal counties compared to the less distressed ones. The daunting challenge for the most heavily coal-dependent counties, their state governments, and federal government supporters is to jointly develop plans that are realistic and affordable, take advantage of local natural and human resources, and offer a path to sustainable existence. If the efforts do not succeed, these places run the risk of becoming politically invisible and their populations are likely to empty out.