Metropolitan and Non-Metropolitan Trends in Coronary Heart Disease Mortality within Appalachia, 1980–1997

Barnett, Elizabeth; Halverson, Joel; Elmes, Gregory; Braham, Valerie E.

doi:10.1016/s1047-2797(00)00058-2

Cited by 48 publications

(36 citation statements)

References 27 publications

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“…Communities in the Appalachian region (i.e., the mountainous region from New York to Mississippi as defined by the Appalachian Regional Commission) suffer from higher rates of cancer incidence and mortality than the rest of the nation, and rates are particularly high for lung, colorectal, and cervical cancer (Barnett et al, 2000;Huang et al, 2002;Halverson et al, 2004;Cakmak et al, 2006). The elevated cancer rates are generally thought to result from high-risk behaviors, such as smoking and physical inactivity, as well as poor access to medical care (Huang et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Hitt

Hendryx

2010

EcoHealth

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Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality.Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health.Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety.

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Section: Introductionmentioning

confidence: 99%

Ecological Integrity of Streams Related to Human Cancer Mortality Rates

Hitt

Hendryx

2010

EcoHealth

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“…Previous research has identiWed that rates of cardiovascular, respiratory, and total mortality are higher in Appalachia compared to the rest of the country (Barnett et al 1998(Barnett et al , 2000Cakmak et al 2006;Halverson et al 2004). Furthermore, heart disease mortality in Appalachia is higher in rural areas of the region compared to metropolitan areas (Barnett et al 1998).…”

Section: Introductionmentioning

confidence: 99%

Mortality from heart, respiratory, and kidney disease in coal mining areas of Appalachia

Hendryx

2008

Int Arch Occup Environ Health

164

127

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“…While death rates due to heart disease have decreased in recent decades (Cooper et al, 2000), vulnerable populations (e.g., individuals in rural areas) persist (Barnett et al, 2000;Pearson et al, 1998). In fact, recent reports indicate that Coronary Artery Disease is 1.3 times more prevalent in rural areas than in urban areas (McCrone et al, 2007).…”

Section: Geographic Statusmentioning

confidence: 99%