Differences in community features could help explain the geographic disparities found in type 2 diabetes (T2D). A growing literature documents that communities with abandoned industrial infrastructure, including coal mine lands with hazards such as spoil piles, open pits, and acid mine drainage, can adversely affect health through impacts on health-related behaviors and stress. We investigated the association between living near abandoned coal mine lands (AML) and new onset T2D through a case-control analysis using electronic health records from a health system in Pennsylvania. We identified cases as persons with new onset T2D (n = 15,888) and frequency-matched controls (5:1, n = 79,435) on sex, age and year of encounter. Residential addresses were geocoded using ArcGIS. We used the Abandoned Mine Land Inventory System database to obtain AML data in Pennsylvania and created variables to represent metrics of AML type and density. We performed logistic regression for each AML variable, adjusting for age, sex, race (white vs. non-white), ethnicity (Hispanic vs. non-Hispanic), and Medical Assistance (≥ 50% of time). The highest quartile (vs. the lowest) of multiple AML variables were associated (odds ratio, 95% confidence interval) with new onset T2D, including the density of physical hazards (1.20, 1.11-1.29), toxic contamination sites (1.17, 1.09-1.26), acid mine drainage impacted streams (1.12, 1.04-1.22), and the density of total mined area (1.18, 1.11-1.25). These findings contribute to the growing literature on geographic disparities in T2D. Further research is needed to investigate the physiologic mechanisms through which these associations may occur.


E. Brown: None. J. S. Pollak: None. A. G. Hirsch: None. B. S. Schwartz: None.


Centers for Disease Control and Prevention (DP006299); National Institutes of Health (T32HP10025)

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