煤矿开采遗留下来的健康问题:英格兰和威尔士随时间变化的死亡率分析(1981-2019 年)

IF 3.6 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Ssm-Population Health Pub Date : 2024-08-13 DOI:10.1016/j.ssmph.2024.101706
Matthew Shaikh
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引用次数: 0

摘要

背景--尽管英国的煤矿业在 20 世纪 90 年代初就已消失,但煤矿区的健康状况仍然较差。失业和贫困被认为是主要原因。然而,由于危险工作环境对健康的影响在该行业关闭后仍在继续,目前尚不清楚这种持续的健康赤字在多大程度上是由于煤矿开采对健康的遗留影响,而不是社会经济因素(包括失业和贫困)造成的。采用倾向得分匹配法将采煤区与非采煤区配对。这样就形成了英格兰和威尔士社会经济相似的地方当局地区样本。我估算了 1981-2019 年煤炭开采对男性和女性年龄标准化时期死亡率的影响,分析了时间动态并检验了趋同性。结果--我发现 1981 年煤炭开采对男性(女性)死亡率的初始影响为每 10 万人 122.6(66.5)例死亡。在此期间,这一影响下降了 91%(70%),表明死亡率趋同。这种趋同的时间与该行业关闭的时间一致,在 20 世纪 90 年代观察到较高的趋同率。结论--这些结果提供了证据,证明煤矿开采对死亡率产生了遗留的健康影响,以及 1981 年至 2019 年期间死亡率的趋同。这种效应对于解释煤矿开采地区的健康赤字非常重要。此外,由于煤矿开采地区往往更加贫困,这些结果还揭示了导致英国近期健康不平等的相关机制。
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The health legacy of coal mining: Analysis of mortality rates over time in England and Wales (1981–2019)

Background

– Coal mining areas in the UK continue to suffer worse health outcomes despite the industry disappearing by the early 1990s. Unemployment and deprivation are cited as key explanations. However, as the health effects of hazardous working environments continue after the industry's closure, it is unclear to what extent this ongoing health deficit is due to the legacy health effect of coal mining versus socioeconomic factors, including unemployment and deprivation.

Methods

– I isolate the legacy health effect of coal mining using a matching research design. Coal mining areas are paired with non-mining areas using propensity score matching. This creates a sample of socioeconomically similar local authority districts in England and Wales. I estimate the effect of coal mining on male and female age-standardised period mortality rates for 1981–2019, analysing temporal dynamics and testing for convergence.

Results

– I find an initial coal mining effect in 1981 on male (female) mortality rates of 122.6 (66.5) deaths per 100,000. This effect decreases by 91% (70%) during this period, indicating convergence in mortality rates. The timing of this convergence is consistent with that of the industry's closure, with higher convergence rates observed during the 1990s.

Conclusions

– These results provide evidence for a legacy health effect on mortality from coal mining and convergence in mortality rates between 1981 and 2019. This effect is important when explaining the health deficit experienced by coal mining areas. Furthermore, as coal mining areas tend to be more deprived, these results also shed light on relevant mechanisms driving recent health inequality in the UK.

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来源期刊
Ssm-Population Health
Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
2.10%
发文量
298
审稿时长
101 days
期刊介绍: SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.
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