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The objective of this study was to estimate the association between residence in coal mining environments and low birth weight. We conducted a cross-sectional, retrospective analysis of the association between low birth weight and mother's residence in coal mining areas in West Virginia. Birth data were obtained from the West Virginia Birthscore Dataset, 2005-2007 (n = 42,770). Data on coal mining were from the US Department of Energy. Covariates regarding mothers' demographics, behaviors, and insurance coverage were included. We used nested logistic regression (SUDAAN Proc Multilog) to conduct the study. Mothers who were older, unmarried, less educated, smoked, did not receive prenatal care, were on Medicaid, and had recorded medical risks had a greater risk of low birth weight. After controlling for covariates, residence in coal mining areas of West Virginia posed an independent risk of low birth weight. Odds ratios for both unadjusted and adjusted findings suggest a dose-response effect. Adjusted findings show that living in areas with high levels of coal mining elevates the odds of a low-birth-weight infant by 16%, and by 14% in areas with lower mining levels, relative to counties with no coal mining. After covariate adjustment, the persistence of a mining effect on low-birth-weight outcomes suggests an environmental effect resulting from pollution from mining activities. Air and water quality assessments have been largely missing from mining communities, but the need for them is indicated by these findings.

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Objectives Early childhood caries (ECC) disproportionately affects lower socioeconomic status households. In this article, we describe a novel intervention utilizing physician‐applied silver diamine fluoride (SDF) in a primary care “Cavity Clinic.” Methods Building on literature review and expert consultation, Cavity Clinic using SDF for children without dentists was implemented in a family medicine residency setting. Process outcomes were evaluated through chart review and structured field notes. Results From December 2017 to December 2018, 30 patients have been treated. Their average age is 5.5 years (2–9), 82 percent are African American, and all are insured by Medicaid. Most have severe ECC. Thirty‐eight percent have successfully established dental homes through participation. Conclusions It is feasible and acceptable for physicians to treat ECC with SDF in a primary care setting. Partnership with an on‐site hygienist is helpful but physician‐only sessions were still beneficial. This strategy holds potential for addressing the epidemic of ECC.

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