Environmental Health

How Does the Coal Industry’s Decline Affect Community Health in the US?

To optimize human health, a just clean energy transition will require intentional job creation in regions economically dependent on coal, findings suggest.

This article was originally published by BU Institute for Global Sustainability.

A well-documented truth: coal mining harms human health. A parallel truth: shuttering mines without consideration for people economically dependent on the industry can harm health, too.

“The key here is that two things can be true at the same time,” says Mary Willis, assistant professor of epidemiology and a core faculty member at Boston University’s Institute for Global Sustainability (IGS). 

Coal generates harmful pollution associated with cardiovascular disease, asthma, cancer, and other serious population health outcomes. While phasing out coal can improve health by reducing exposure to pollution and dangerous working conditions, the coal industry has also provided stable employment associated with increased average life expectancy, according to a new study published in Rural Sociology by Willis and colleagues. 

The study is the first to concurrently examine three aspects of coal production suspected to affect life expectancy: community pollution, hazardous working conditions for miners, and job security. This broad approach helped capture important next steps toward a just energy transition that supports human health, the researchers say. 

“As we move away from fossil fuels, we also need to ensure that communities historically dependent on industries like coal have replacement jobs available,” Willis says. “Improving health is a bit more complicated than just getting rid of the polluting industry.”

Decades of research have linked unemployment to worsened health outcomes, Willis adds. Economic distress can elevate the risk of mental health concerns, substance misuse, and other health problems, shortening a region’s average life expectancy. 

In the U.S., employment in the coal industry has fallen over the last nearly 100 years, and total coal production peaked in 2008. The study considered data from close to 98% of U.S. counties, gathered between 2012 and 2019. 

Using a novel methodology, the researchers examined effects both within a given county and in those nearby, accounting for individuals who may travel for work. 

Key Findings

• In coal-producing counties, average life expectancy was 1.6 years lower than in typical, non-coal-producing counties. Coal-producing regions were also more economically distressed. 
• As coal production fell in Appalachia, a national coal hub, average life expectancy increased—but this connection was weaker in other regions with less coal production. This indicates that a high density of coal-producing facilities can generate health-harming pollution. 
• As miner labor hours decreased, average life expectancy increased. Miners face numerous occupational hazards, including the risk of fires, mine collapses, and acute and chronic lung diseases.
• As jobs in the coal mining industry decreased in a county, so did life expectancy, especially in Appalachia. This suggests that a waning coal industry can worsen economic distress in communities where the industry is prevalent.

“We chose to zoom in on Appalachia because it’s the region that’s most dependent on coal in the country,” Willis says. “If we’re going to see stronger effects anywhere, it should be Appalachia.”

Economic stability is an example of a social determinant of health, a non-medical, lifestyle factor that can influence wellbeing. The research team says this is the first study they know of to merge the Social Determinants of Health framework with the Just Transition framework, which energy scholars use to conceptualize a transition to a clean energy future grounded in equity and fairness. Public health and energy scholars collaborated on the publication. 

“Incorporating both frameworks helped us consider economic, occupational, environmental, and health factors, giving this topic the thoughtful approach it deserves,” says Benjamin Sovacool, director of IGS and a coauthor on the study. “We capture nuances that we would have missed in examining a single county or a single pathway through a single lens. Studies like this one demonstrate the importance of interdisciplinary research that transcends academic siloes and helps identify ways forward.”

Based on these findings, the research team recommends policies to transition workers to lower-carbon industries, increase labor protections, and strengthen social welfare programs.

In addition to Willis and Sovacool, the study’s coauthors include Jonathan J. Buonocore, assistant professor of environmental health & an IGS core faculty member, Ryan P. Thombs, assistant professor of rural sociology at The Pennsylvania State University, and Andrew K. Jorgenson, professor of sociology at The University of British Columbia. In spring 2024, with funding from IGS and SPH, Willis and Buonocore launched the Energy Infrastructure Exposure Intensity and Equity Indices (EI3) Database for Public Health to compile data on fossil fuel energy infrastructure. The database will enable continued studies at the intersection of fossil fuels and health. 

The study, “A Not-So-Just Transition? Examining the Effects of Coal Sector Decline on Life Expectancy in U.S. Counties,” is fully available to the public.