Abstract
Natural resource extraction projects are often accompanied by complex environmental and social-ecological changes. In this paper, we evaluated the association between commodity extraction and the incidence of diseases. We retrieved council (district)-level outpatient data from all public and private health facilities from the District Health Information System (DHIS2). We combined this information with population data from the 2012 national population census and a geocoded list of resource extraction projects from the Geological Survey of Tanzania (GST). We used Poisson regression with random effects and cluster-robust standard errors to estimate the district-level associations between the presence of three types of commodity extraction (metals, gemstone, and construction materials) and the total number of patients in each disease category in each year. Metal extraction was associated with reduced incidence of several diseases, including chronic diseases (IRR = 0.61, CI: 0.47–0.80), mental health disorders (IRR = 0.66, CI: 0.47–0.92), and undernutrition (IRR = 0.69, CI: 0.55–0.88). Extraction of construction materials was associated with an increased incidence of chronic diseases (IRR = 1.47, CI: 1.15–1.87). This study found that the presence of natural resources commodity extraction is significantly associated with changes in disease-specific patient volumes reported in Tanzania’s DHIS2. These associations differed substantially between commodities, with the most protective effects shown from metal extraction.
Highlights
Implementation of natural resource extraction projects often triggers a series of complex environmental and social–ecological changes [1,2,3,4]
A total of 2 districts were exposed to all 3 types of commodity extraction, 5 districts were exposed to 2 types of commodity extraction, and 38 districts exposed to only 1 type of commodity extraction
In the fully adjusted models, we found that the presence of construction material extraction was associated with an increased incidence of chronic diseases
Summary
Implementation of natural resource extraction projects often triggers a series of complex environmental and social–ecological changes [1,2,3,4] These changes include increased population growth and urbanization, infrastructure improvements, movement and installation of heavy machinery, changes in land use, increased business and economic opportunities, and household resettlement [5,6,7]. Such changes can positively or negatively affect the health status of communities in proximity of resource extraction activities [8,9,10,11,12].
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