Coalfield Generations: Health, Mining, and the Environment
Earl Dotter, Photographer
Essay Sections:
Introduction | Town Life | Health Issues and Healthcare | Working at the Mines | Mining and the Environment | Recommended Resources
Photo Essay: Health Issues and Healthcare
This sequence of photographs begins in Appalachian clinics, highlighting the emblematic mining disease black lung, as well as the rise of diabetes. Healthcare, its quality and access, has changed thanks to the work of people like Dr. Donald Rasmussen; however, health problems still trouble coalfield communities. There is a physician shortage and patients often have to travel considerable distances on poor roads to reach healthcare providers. Lack of adequate insurance also impedes disease prevention and treatment, particularly as the coal industry restructures, laying off younger workers and leaving them and their families without medical coverage.
Chronic and rapidly increasing rates of obesity-related diseases, as illustrated in the first pictures in this series, are the result of changing working conditions, lifestyle choices, and consumption patterns.
Although black lung is not as prevalent as it was twenty years ago, the remaining pictures in this series attest to its persistence among miners. Dr. Rasmussen, pictured administering care and in his office, has worked with miners since the 1960s, collaborated with lawmakers on legislation for black lung compensation. The final two pictures evoke earlier generations of black lung through the remembrance of two miners' fathers.
Problems associated with older generations of miners, such as a lack of healthcare providers, under-nutrition, inadequate medical benefits, and black lung treatment, have improved; however, new diseases, particularly those relating to consumption and to changing working conditions, are causing new problems. In his 2008 interview with Southern Spaces (excerpted below), Dotter discusses some images and issues in more detail.
Chronic and rapidly increasing rates of obesity-related diseases, as illustrated in the first pictures in this series, are the result of changing working conditions, lifestyle choices, and consumption patterns.
Although black lung is not as prevalent as it was twenty years ago, the remaining pictures in this series attest to its persistence among miners. Dr. Rasmussen, pictured administering care and in his office, has worked with miners since the 1960s, collaborated with lawmakers on legislation for black lung compensation. The final two pictures evoke earlier generations of black lung through the remembrance of two miners' fathers.
Problems associated with older generations of miners, such as a lack of healthcare providers, under-nutrition, inadequate medical benefits, and black lung treatment, have improved; however, new diseases, particularly those relating to consumption and to changing working conditions, are causing new problems. In his 2008 interview with Southern Spaces (excerpted below), Dotter discusses some images and issues in more detail.
Earl Dotter:
Changes in healthcare: The whole healthcare system has changed to a great extent. The miners who are actively working continue to have a fairly useful health benefit plan that provides them with healthcare and with medications. They have local providers, their own physicians, or their primary care facilities in their communities to access. What's different is there are so many coalminers of working age who have been laid off and left high and dry and whose health benefits soon disappear. I profiled a local UMWA worker who was so impacted in Kanawha County, West Virginia. There were coalminers in their fifties and late forties who had lost their jobs at a mine where they had worked for fifteen or eighteen years, just short of retirement and of being eligible for lifetime healthcare. One miner had lost his house and was sleeping in the local union hall. I followed him to a free clinic in Clay County, some distance away, where he was getting medication for hypertension, heart problems, and early-onset diabetes.
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Healthcare also becomes a major issue when coal companies purchase facilities, shut down the operations, lay off the miners, then reopen under new corporate settings. These new companies do not rehire the miners who were active under the previous contract. Instead of hiring the local workers who have worked in a mine for generations, the new management will employ workers who drive fifty, sixty miles from adjacent counties to work in that facility. That's a strategy that plays on the fact that miners are not all working from the same community that was adjacent to the mines.
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Generations of miners: This project was an opportunity for me to reconnect with the next generation of coalminers that I had worked with back in my days with the UMW Journal. The cover of my book, The Quiet Sickness featured the photograph of Lee Hipshire, a deep miner who had died of black lung at the age of fifty-seven. I had met several of his sons at the time I photographed Lee. This exhibit gave me the opportunity to look up his sons who were still working in the coalmines. I found Lee Hipshire, Jr., and another brother who was working at the mountaintop removal site in Boone County. I was able to profile their family life some forty years since my initial coverage with the Mine Workers Journal. |
Distance and healthcare: One of the problems that leads to severe cases of illness is the distance residents have to travel to healthcare facilities. Because it's a high cost item to have to travel these days from a remote location to a health care facility, health problems tend to get addressed later rather than sooner in the coalfields. This leads to higher rates of cancer, diabetes, and other chronic diseases. |
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On Dr. Donald Rasmussen: To the extent you have a network within the coalfields, you can open doors that would not ordinarily be available. I knew Doc Rasmussen back in 1978 and he appreciated the work that I did in that era when I was active in not only helping miners but also advocating improvements in state and federal mining dust laws and compensation law. He appreciated the fact that I was returning three decades later to resume my documentation of his work with black lung victims. |
Essay Sections:
Introduction | Town Life | Health Issues and Healthcare | Working at the Mines | Mining and the Environment | Recommended Resources
