Coal Mining History and COVID-19 Vaccine Hesitancy in Wales and Appalachia

Introduction

This study examines 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. Both regions share a distinctive industrial heritage shaped by coal extraction, and both have experienced the prolonged social and economic consequences of deindustrialization. By situating vaccination outcomes within this historical framework, the study aims to explain why post-industrial communities exhibit health behaviors that diverge from national averages and from communities with no significant mining legacy.

The central argument is that the legacy of coal mining — and, crucially, the timing of mine closures — continues to shape the social values, institutional trust, and collective identities that inform how residents make health decisions today. Understanding these dynamics is essential for designing effective, culturally resonant public health interventions in communities that have historically been underserved and politically marginalized.

Coal Mining History and Socio-Economic Context

Wales and Appalachia represent two of the most emblematic coal-producing regions in the English-speaking world. In both cases, coal mining did not merely drive economic activity — it organized entire communities around shared labor, mutual aid, and trade union solidarity. The South Wales Coalfield and the coalfields of Kentucky, West Virginia, and surrounding Appalachian states generated deeply rooted cultures of collective action that persisted long after the industry itself declined.

The timing of deindustrialization differed across sub-regions. Some communities saw mines close before 1960 as early mechanization rendered operations unviable; others experienced closure waves following the industrial restructuring of the late 1970s and 1980s, particularly in the aftermath of the 1984–85 miners' strike in Britain and the broader collapse of the American coal industry. These varying timelines produced distinct socio-economic trajectories, with implications for community cohesion, institutional trust, and long-term health outcomes.

Study Design and Methodology

The study employed a mixed-methods design, combining large-scale survey data with in-depth qualitative interviews. Survey data were collected from 4,187 participants in Wales and 4,864 participants in Appalachia, yielding a combined sample of over 9,000 respondents. Regions were categorized according to their historical engagement with coal mining: areas where mines closed before 1960, areas where mines closed after 1979, and areas with limited or no coal mining history.

The quantitative component measured vaccination rates, vaccine confidence, COVID-19 skepticism, and attitudes toward vaccine individualism — defined as the belief that vaccination is a personal rather than a collective or civic responsibility. The qualitative component consisted of in-depth interviews designed to explore the values, narratives, and lived experiences that underpin these measurable differences. Together, these two methodological strands allowed the research team to move from describing the pattern of disparity to explaining the cultural and historical mechanisms that produce it.

Quantitative Findings on Vaccination Behaviors

The quantitative findings reveal a clear and consistent disparity in health behaviors and attitudes between areas with a substantial coal mining legacy and those without. Regions where mines closed after 1979 or before 1960 exhibit lower vaccination rates, diminished vaccine confidence, heightened COVID-19 skepticism, and a stronger inclination toward vaccine individualism. This pattern holds across both Welsh and Appalachian communities, suggesting that it reflects a structural feature of post-industrial deindustrialization rather than a phenomenon unique to one national or cultural context.

Notably, the relationship between mine closure timing and vaccination outcomes is not linear. Communities where mines closed at different historical junctures exhibit different profiles of hesitancy, suggesting that the circumstances of deindustrialization — including the degree of economic disruption, political conflict, and institutional abandonment experienced — matter as much as the fact of closure itself. These nuances underscore the importance of granular, historically sensitive analysis when studying vaccine hesitancy in post-industrial populations.

Conclusion

This research highlights the importance of acknowledging and integrating historical and cultural contexts in public health strategies, particularly in regions that continue to struggle with the long-term effects of deindustrialization. The study advocates for a nuanced, contextually informed approach to health promotion — one that bridges the gap between historical injustices and contemporary health disparities.

The convergence of findings across Wales and Appalachia strengthens confidence in the study's core thesis: that the timing and circumstances of coal mine closures have left a measurable imprint on community health attitudes that persists decades later. Future public health initiatives targeting post-industrial communities should treat this historical legacy not as background context but as a primary variable shaping how residents understand health, trust, and collective responsibility.