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Abstract
This study examined the relationship between coal mining history, socio-economic impacts, and public health responses in Wales and Appalachia, with a specific focus on Covid-19 vaccination behaviors and attitudes. The study drew on survey data from 4187 participants in Wales and 4864 in Appalachia, as well as in-depth qualitative interviews. The research categorized regions based on their historical engagement with coal mining and focused on vaccination rates, confidence, and hesitancy to describe public health in post-industrial communities.
The findings show disparity in health behaviors and attitudes between areas with a considerable coal mining legacy and those without. Regions where mines have closed since 1979 or before 1960 exhibit lower vaccination rates, diminished vaccine confidence, heightened Covid scepticism, and a stronger inclination towards vaccine individualism. This pattern is consistent across both Welsh and Appalachian communities.
Qualitative interviews support these quantitative insights, showing that vaccinated individuals frequently contextualize their health choices within a legacy of community solidarity and collective action, a sentiment rooted in the regions rich trade union history. Conversely, unvaccinated individuals tend to frame their health decisions as rational, individual choices, revealing a more individualistic ethos.
This research highlights the importance of acknowledging and integrating historical and cultural contexts in public health strategies, particularly in regions that struggle with the long-term effects of deindustrialization. The findings hold significant implications for future public health initiatives, the ongoing transition towards a decarbonized economy, and the integration of artificial intelligence in community health. The study advocates for a nuanced, contextually informed approach to health promotion, to bridge the gap between historical injustices and contemporary health disparities.
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