Spend enough time driving through Central Appalachia, and you’ll see lush green mountain ranges brimming with diverse plant and animal species. Within those mountains, though, you can also find some of the most dramatic human health disparities in the nation.

Past studies going back to the 1970s indicate heightened incidences of chronic disease and early death in the region. Rates of cancer, cardiovascular disease, and respiratory problems are elevated compared to other regions of the United States, according to an interdisciplinary Virginia Tech research team that spans the sciences and humanities.

In a literature review published in the journal Reviews on Environmental Health, the team argues that more research needs to be conducted to determine how the unique topography and industries of the region, including coal and natural gas, impact the health of people living in the region.

So far, a great deal of research has looked at how resource extraction affects biodiversity. Other research has examined the prevalence of lifestyle-related human health issues, such as obesity and type 2 diabetes in the Appalachian region. But relatively little research has examined the connection between resource extraction and human health, the authors write.

The team, which includes researchers from biological systems engineering, civil and environmental engineering, Appalachian studies, geography, and population health sciences, originally assembled in 2014, and then in 2015, received support from a $20,000 seed grant from the Global Change Center at Virginia Tech and the Institute for Society, Culture, and Environment (ISCE).

“Given the complexity of issues affecting people and places in Virginia and beyond, the partnership between the Global Change Center and ISCE is a strategic effort to support and encourage faculty with expertise in the social sciences, biophysical sciences, and engineering to strategically address social aspects of major global change,” said Karen Roberto, director of the Institute for Society, Culture, and Environment, and a University Distinguished Professor in the Department of Human Development in the College of Liberal Arts and Human Sciences. This support helped them to conduct preliminary research, such as interviews with Appalachian residents and preliminary water and air testing. Their findings during these trips — mostly to Virginia’s Tazewell County — drove them to complete a comprehensive literature review to determine gaps in research thus far.

“Our early site visits and interviews in Appalachia convinced us that there is a connection between the environment and human health that is worth looking into,” said Leigh-Anne Krometis, an associate professor of biological systems engineering in the College of Agriculture and Life Sciences and lead author of the study. “We are grateful to the Global Change Center and ISCE for this early exploratory funding, which has identified a great need and led to a much larger project.”

In June, the team was awarded $75,000 to expand and continue their project for another year under the Global Systems Science Destination Area. Their project, entitled “Ecological and Human Health in Rural Communities,” will initially focus on Central Appalachia, but may eventually grow to include rural communities worldwide, including portions of India, China, Malawi, and Ecuador, where they could build on existing investments by the university.

The project’s concept paper states, “We are motivated by the [university’s] motto Ut Prosim to serve the surrounding region and fulfill Virginia Tech’s mission as a land grant university with global reach, going ‘beyond boundaries’.” Ut Prosim translates to “That I May Serve.”

“We are supporting this effort because it is in line with the university’s goal of aggressively merging multiple areas of academic excellence — including experimentation, analytics, modeling, and policy — in ways that could result in practical social and environmental benefit while also providing our students opportunities for relevant and meaningful research experiences,” said Dennis Dean, director of the Fralin Life Science Institute.

Globally, more than 3.4 billion people live in rural areas, and these areas remain critical for energy and food production. Published estimates suggest that even under predictions of high natural gas production and low coal demand, almost 1,000 square kilometers of new mine development is expected in the next 20 years in the Central Appalachia region.

“For years, community residents in Central Appalachia have expressed uncertainty and concern regarding the cumulative effects of a variety of factors on human health,” said study coauthor Emily Satterwhite, an associate professor in the Department of Religion and Culture in the College of Liberal Arts and Human Sciences. “Virginia Tech has an important role to play in partnering with local communities to examine and address issues of environmental justice.”

Mountaintop mining in Harlan County, Kentucky. Photo courtesy of Leigh-Anne Krometis.

Linsey Marr, a professor of civil and environmental engineering in the College of Engineering and coauthor, studies air pollution and will continue to research links between air quality and human health in the region for the project.

“Rural areas are often neglected in the national discussion about air pollution,” said Marr. “We usually assume that air quality in rural areas is good, but there are different sources of pollution and patterns of human exposure that deserve further study.”

Other authors include Julia Gohlke, an assistant professor of population health sciences in the Virginia–Maryland College of Veterinary Medicine; Korine Kolivras, an associate professor of geography in the College of Natural Resources and Environment; and Susan West Marmagas, an associate professor of population health sciences in the Virginia–Maryland College of Veterinary Medicine.

Written by Lindsay Key