There is a fundamental gap in understanding how key population subgroups contribute to health disparities within larger populations. One such key subgroup includes those who reside in rural Appalachian coal mining communities. Profound health disparities are not uniformly distributed throughout Appalachia but are concentrated in these communities. Continued existence of this knowledge gap represents an important problem because, until it is filled, the national goal to eliminate disparities and improve the health of all groups will not be achieved. Guided by strong prior data, the health problems experienced by this group cannot be resolved by attending only to conventional risks from socioeconomic, behavioral, or health care disadvantages, but also require attention to understanding how environmental pollution from activities of the mining industry contribute to population health inequities. The long term goal is to better understand and subsequently reduce the contributions of environmental pollutants to poor health outcomes in this population. The objective in this particular application is to identify the ambient and personal exposure levels of two important classes of chemicals, polycyclic aromatic hydrocarbons (PAHs) and flame retardants (FRs), among residents of rural communities with and without surface coal mining, and relate levels of these chemicals to biological markers of effect. [The study will include 120 adults who live either within two miles of active surface coal mining in West Virginia, or in matched communities at least 40 miles from mining. Participants will complete a health interview and provide a blood sample to measure inflammation and thyroid function. They will also wear a silicone wristband for passive sampling of PAHs and FRs. Indoor and outdoor sampling of PAHs and FRs in mining and control communities will also be undertaken. Importantly, high school and college students will be recruited as research assistants and will gain meaningful experience through this R15 mechanism. Students will also make essential contributions to implementing a communications plan to inform local stakeholders of study results.] The approach is innovative because it examines a previously unrecognized source of exposure to these chemicals in a novel population, and because it employs silicone wristbands as novel, inexpensive, passive samplers that can lead the way to larger scale exposure monitoring studies. The proposed research is significant because it promises to offer essential new information on the drivers of health disparities in a high priority population and provides the community with actionable results. Ultimately, such knowledge has the potential to pave the way toward the reduction and elimination of health inequities that have long resisted conventional efforts to change; instead, knowledge on previously unrecognized environmental contributions can lead to appropriate behavioral and policy interventions to reduce health inequities for this population.
The proposed research is relevant to public health because it promises to contribute to understanding and reducing population health disparities for a high priority group, specifically, residents of rural Appalachian coal mining communities. Thus, the proposed research is relevant to the part of NIH's mission that pertains to reducing and eliminating health disparities across population groups.
