Coal Mining Communities Research Articles

Comparative Analysis of Indoor Air Quality in Coal Mining Communities During Wet and Dry Seasons in the Coal Mining Belt of Kogi East, Nigeria

This study investigates the indoor air quality in coal mining communities during wet and dry seasons in the coal mining belt of Kogi East, Kogi State, Nigeria. The research was conducted at selected coal mining sites, specifically the Ika-Ogboyaga and Okaba mine sites, using a randomized sampling method. Indoor air quality data were collected from fifteen households in Ika and Odele villages within a 500-meter radius of the mining sites. Monitoring was performed using the Gasman autosampler to measure concentrations of nitrogen dioxide (NO₂), sulphur dioxide (SO₂), carbon monoxide (CO), hydrogen sulphide (H₂S), and particulate matter (PM₂.5 and PM₁₀). Data collection spanned 7 days each for the wet season (October 2022) and the dry season (February 2023), with measurements taken thrice daily. Meteorological parameters such as temperature, wind speed, wind direction, and relative humidity were also recorded. The results indicated higher pollutant concentrations during the dry season. For instance, PM₂.5 levels in Ika during the wet season were 45.3±0.25 μg/m³ (morning), 74.6±0.49 μg/m³ (afternoon), and 56.26±0.1 μg/m³ (evening), while dry season values were 48.32±1.74 μg/m³ (morning), 74.12±0.30 μg/m³ (afternoon), and 56.9±0.75 μg/m³ (evening). Similarly, PM₁₀ levels in Ika during the wet season were 73.61±1.44 μg/m³ (morning), 105.53±0.44 μg/m³ (afternoon), and 99.01±0.5 μg/m³ (evening), whereas dry season values were 75.47±0.70 μg/m³ (morning), 102.08±1.48 μg/m³ (afternoon), and 96.98±1.33 μg/m³ (evening). CO concentrations in Ika during the wet season were 4.22±0.22 ppm (morning), 6.13±0.3 ppm (afternoon), and 3.1±0.05 ppm (evening), and during the dry season, they were 5.55±1.74 ppm (morning), 8.11±1.46 ppm (afternoon), and 7.04±1.184 ppm (evening). Meteorological analysis showed that the dry season had higher wind speeds (2-4 m/s) compared to the wet season (0-2 m/s), and lower relative humidity (mean of 51.18%) compared to the wet season (mean of 77.55%). Air Quality Index (AQI) values indicated that PM₂.5 levels in both seasons were unhealthy (155.8-156.4 in the wet season and 151-200 in the dry season), while PM₁₀ levels were moderate (65.5-66.9 in the wet season and 51-100 in the dry season). CO, NO₂, and SO₂ levels generally remained within permissible limits set by the World Health Organization (WHO). Statistical analysis revealed significant seasonal variations in the concentrations of the monitored pollutants, with higher levels typically recorded during the dry season.

Politics of a Just Transition: lessons from the UK coal mines

ABSTRACT The concept of a Just Transition [JT] gained considerable international interest as exemplified by a dedicated pavilion set up for the JT by the European Commission and the ILO at the COP27. Although the concept now encompasses a wide range of justices such as the social, legal, and environmental justices, the original concept itself can be traced back to trade union movements in the 1980s. Drawing lessons from the socio-economic damage caused by a failed JT of the UK mine closures between the 1980s and 1990s, this paper argues that former coal mining communities in the UK today continues to face similar problems identified in the past, which makes them uniquely vulnerable against the current process of JT. This paper utilises the multi-level perspective [MLP] theory by fleshing out the role of politics and policy in enabling a JT, using a case study approach to the coal mine closure in the North of England. This paper identifies the failed JT at every stage of the MLP theory. It concludes that the example of the coal mine closures provides a valuable lesson for a successful JT today such as stronger key stakeholder cooperation and a place-based response through significant decentralisation.

Analysis of Residents’ Livelihoods in Transformed Shantytowns: A Case Study of a Resource-Based City in China

Research on shantytown transformation in the context of building sustainable human settlements has tended to concentrate on macro and objective factors. However, there is still room for expanding research on the livelihoods of residents in transformed poor communities of resource-based cities. This study is based on household survey data after the coal mine shantytown transformation in Datong, China, and uses the entropy method and Logit regression model to analyze the livelihood level and impact of livelihood capital on the choice of livelihood strategies of the residents after shantytown transformation. Based on the development characteristics of the Datong coal mining community, the traditional sustainable livelihood analysis framework is improved, constructing a livelihood capital evaluation system including natural capital, physical capital, financial capital, social capital, human capital and cultural capital. The research indicates that the livelihoods of the residents after shantytown transformation are in a state of low-value aggregation and differentiation, their livelihood strategies are still dependent on coal mining, financial capital and cultural capital have significant positive impacts on the residents’ livelihood strategies of choosing coal mine-related industries, and males and elderly people have a greater likelihood of choosing coal mine-related industries. This study provides micro-level explanations for the livelihood status and livelihood strategy choices of residents after shantytown transformation in a resource-based city and provides policy enlightenment for local governments on how to promote the sustainable development of residents in coal mining communities.

Evaluation of the heavy metal levels from selected food cultivars, from coal mining communities of Enugu State, Nigeria

Food cultivars from Akwuke, Ngwo and Udi were analyzed for their heavy metal content using the atomic absorption spectrometry (AAS). The mean concentrations of Manganese in leafy vegetable ranges from 1170±6.20µg/g and in chromium from 110±0.0 µg/g, in lead from 320±210, in cadmium from 30±10 µg/g and nickel from 10±0 µg/g all in Akwuke. The transfer factors results for the three communities shows that the pumpkin leafy have the highest transfer factor for manganese, 2.6 in Akwukeand chromium yam 2.465 in Udi, while Nickel has the least transfer factor in all the food cultivars in the three communities with 0 result. This study has revealed high concentration of manganese, lead, chromium cadmium and nickel in food cultivars in the three studied area Akwuke, Ngwo and Udi, all in Enugu State. Though the concentrations of these heavy metals were not high in any of the soil samples, but high concentration of these heavy metals, compared to WHO/FAO in food cultivars were observed, especially in Udi and Ngwo community. Keywords: Heavy metal, levels, food cultivars, Enugu State and Nigeria

Evaluation of the heavy metal levels in soil and water from coal mining communities of Enugu State, Nigeria

Water and soil from Akwuke, Ngwo and Udi were analyzed for their heavy metal content using the atomic absorption spectrometry (AAS). All the well water samples were found to be higher in heavy metal concentration when compared with the WHO permissible limit, except nickel in drinking water. The soil samples in the three communities were found to have lower concentration of Mn, Cr, Pb, Cd, and Ni when compared to the WHO permissible limit in soil. This study has revealed high concentration of manganese, lead, chromium, cadmium and nickel in water samples in the three studied area Akwuke, Ngwo and Udi, all in Enugu State. Though the concentrations of these heavy metals were not high in any of the soil samples, but high concentration of these heavy metals, compared to WHO/FAO in well water was observed, especially in Udi and Ngwo community. Keywords: Heavy metal, levels, soil and water.

Past and present: Immigration and museum exhibitions in the anthracite coal region

AbstractNortheastern Pennsylvania was home to the anthracite coal industry for about two centuries. The area was originally settled by various waves of immigrants, first from western then southern and eastern Europe. The new immigrant miners faced many forms of prejudice and were exploited in a system of unchecked capitalism. They were racialized and placed at the bottom of the job hierarchy. Some capitalists did not consider them human, and therefore not deserving of safe working conditions, descent housing and equal pay. At the turn of the twenty‐first century, a new wave of Hispanic immigrants from the Caribbean, Mexico, and South and Central America entered the region to work mainly in low‐paying fulfillment center jobs. Their arrival is being met with various forms of xenophobia, much like the immigrant miners faced over a century ago. The online exhibition “We Are Anthracite,” hosted by the Anthracite Heritage Museum, addresses the call from the American Alliance of Museums for museums to be civically engaged, build social capital and connecting new populations to place. The exhibition bridges the experiences between the past coal mining communities and new Hispanic immigrants. The state‐operated museum hosting this exhibition lends validity to the new immigrants' place in this region, creating a narrative that their experiences are similar to the region's inhabitants' ancestors. By connecting common experiences, past and present, we are creating a form of bridging social capital that connects these different populations. While the northeastern Pennsylvania immigrant story is not well‐known, it is rich and complex like many Rust Belt communities undergoing similar major demographic shifts.

Anthracite memories: semantic tagging and coal mining oral histories

ABSTRACT Oral histories are a critical source of information about lived experiences of past events. They have been analysed both for their form – linguistically as texts, performances, and expressive accounts – and their content for understanding historic events and personal experiences. Here we focus on sentiment analysis approaches frequently applied to big data research questions, but less often utilised by anthropologists working with oral histories. Oral histories collected half a century ago in the anthracite mining communities of northeastern Pennsylvania are examined by considering methodological and historical questions. This project explores how oral history and data science might be productively combined to understand these now historic communities’ everyday lives and working conditions. Bakhtin’s (1981) concept of chronotope helps us understand the memory of these anthracite coal mining communities’ daily life and working conditions.

Perception and legacy of soil chromium and lead contamination in an operational small-scale coal mining community.

Operational small-scale coal mining (OSCM) is one of the most significant sources of chromium (Cr) and lead (Pb) pollution in Bangladesh. Attempts to minimize or lessen the use of Cr and Pb in OSCM have shown unsatisfactory results, mainly because they need to address the sociotechnical complexity of pollution concerns in OSCM. This research adopts a multidisciplinary, sociotechnical approach to addressing Cr and Pb problems, coupling soil sampling for Cr and Pb with questionnaires of miners' and inhabitants' perceptions of pollution and its distribution. The study was undertaken in the Barapukuria coal basin in northwest Bangladesh. Except for mining areas (average of 49.80 ± 27.25mg/kg), Cr levels in soils exceeded the world average in the periphery (73.34 ± 24.39mg/kg, ~ 1.2 times) and residential areas (88.85 ± 35.87mg/kg, 1.5 times the world standard of 59.5mg/kg). Pb levels in soils exceeded national and global averages in mining (53.56 ± 37.62mg/kg, ~ 1.9 times), periphery (35.05 ± 21.77mg/kg, ~ 1.3 times), and residential areas (32.14 ± 26.59mg/kg, ~ 1.2 times) when compared to Bangladesh and global standards of 20 and 27mg/kg. Pb levels were highest in mining areas, while Cr concentrations were highest in residential areas. The questionnaire findings indicated that miners and inhabitants did not correctly assume that the highest levels of Cr and Pb pollution would be found in these areas. Among all respondents, 54% are unaware of the health impacts of prolonged Cr and Pb exposure. They face respiratory problems (38.6%), skin diseases (32.7%), and other health issues. A large number of people (66.6%) agreed with the fact that Cr and Pb contamination has an impact on drinking water. Cr and Pb pollution has caused 40% crop loss and a 36% decrease in productivity in the agricultural sector. However, respondents underestimated the level of Cr pollution in mining areas, and most assumed that only individuals working directly with mines were impacted by the Cr and Pb content. Participants also rated the reduction of Cr and Pb contamination as of low importance. There is less awareness of Cr and Pb pollution among miners and inhabitants. Sincere efforts to reduce Cr and Pb pollution will likely be met with extra attention and hostility.

Remembering Herbert Gutman's Work, Culture, and Society Fifty Years On

Remembering Herbert Gutman's <i>Work, Culture, and Society</i> Fifty Years On

Strategi Gabungan Kelompok Tani Dalam Memberdayakan Petani Di Sekitar Area Pertambangan Batu Bara

Manunggal Jaya village is one of the food sheds that are in Kalimantan Timur. But as the age developed this village changed.This is a sign of the farming land that has begun to narrow. Irrigation was disrupted due to coal mining activities and communities exposed to waste from the mining. Farming land that began to shrink, irrigation disrupted due to coal mining activities and communities exposed to waste from the mining. As for the study's purpose: (1) to know the multi-use farm program in the middle of the coal mine, and (2) knew the combined strategy of farm groups to empower farmers in the middle of the coal mine area. This research uses descriptive qualitative methods through observation techniques, interviews and documentation. The results of research obtained by researchers in accordance with observation programs of empowerment cannot be felt by any farmer and are not carried out evenly because of minimal skills of agricultural and facility skills. The program implemented by the combined farming groups is the training of themes and materials organized according to existing agricultural potential, like giving the training of the stool dose according to the instructions, control of pests and diseases on plants, Home Food Training, and training system plant training line legowo. Whereas the combined strategy of the multi-purpose farming group is the development of human resources, The development of the group, The capital of the world is the, development of productive activities, and providing the right information for.

In Memoriam – Thomas S. Gladsky

Tom Gladsky was born August 26, 1939, in the coal-mining community of Shenandoah, Pennsylvania. He passed away March 30, 2022, in Monroe Township, New Jersey, where he and his wife Rita had retired after long academic careers. A scholar in her own right, Rita passed away just five weeks before Tom, on February 21, 2022.Gladsky earned degrees in history and English education from Bloomsburg State Teachers College—now Bloomsburg University of Pennsylvania—before going on to receive an MA in English from the University of Arizona and a PhD in American Literature from the University of North Carolina-Greensboro.He joined the English Department at the University of Central Missouri, where he later served as Interim Dean of Graduate Studies, and continued his administrative career as Dean of the Graduate School and International Programs at Eastern Illinois University. While there he formed the Polish/Eastern European Cultural Interest Group for students. He later served as Academic Dean at St. Mary's College, Orchard Lake, Michigan, helping to develop the Polish and East Central European Studies Program before the college closed in 2003.Gladsky's interest in his Polish roots, combined with his literary studies, also led him to spend considerable time in Poland. He was a Fulbright Professor at Marie-Curie Sklodowska and Jagiellonian Universities, as well as a guest lecturer at the University of Rzeszow's Institute of English Studies.Princes, Peasants, & Other Polish Selves: Ethnicity in American Literature, Gladsky's 1992 study, helped ensure a place at the table for Polish American writing in the field of ethnic American literature and Polish American studies. His next book, Something of My Very Own to Say: American Women Writers of Polish Descent, which he edited with Rita Holmes Gladsky, helped open the door to what is now a well-established focus on Polish American women and on gender issues. Something of My Very Own to Say won PAHA's 1999 Halecki prize. Gladsky's stint as Project Director of PAHA's Polish American Memoirs Project underscores his interest in the making a space for the under-represented voices within Polonian history. In addition to his work on Polish American literature, Gladsky published on Polish literary figures like Jerzy Kosinski.Tom Gladsky served as PAHA president from 1998–2000, and in 2002 received the Haiman award for “sustained contribution to the study of Polish Americans.” He helped shape the universe of Polish American Studies as we now know it, and left a lasting legacy to this organization and to the scholars who took inspiration from his work.

Mining, loss, and despair: Exploring energy transitions and opioid use in an Appalachian coal community

The opioid epidemic has ravaged the United States, resulting in the highest number of opioid-related overdose deaths on record in 2020–2021. This phenomenon, often associated with “deaths of despair”, has acutely impacted Central Appalachia. Despite rapidly evolving literature on deaths of despair, limited research has been conducted to evaluate how coal mining and energy transitions relate to opioid use. We address this gap through a case study in Logan County, West Virginia, a region heavily impacted by the opioid epidemic with a strong history of coal mining. In 2021, Logan County was the fourth largest coal producing county in the state and first in opioid-related mortality rate. We conducted 14 semi-structured key stakeholder interviews in late 2019 to better embed deaths of despair in Logan County within the broader economic, cultural, and social realities of a rural coal mining community. We identified two key themes to explain the coal-energy transition-opioid nexus relationship: “ripple effects and despair” and “barriers to treatment and harm reduction resources.” These themes explore the connections between coal decline, broader economic distress, and increasing opioid use, as well as the sociopolitical challenge of expanding mental health and substance abuse services. Our results identify a major gap in energy transition scholarship and policy, namely, the need for further investigation into how the pursuit of low carbon energy transitions may negatively impact health and economic well-being in extractive fossil fuel landscapes. Low carbon energy transitions cannot be just without attending to these dimensions.

Assessing coal mine closures and mining community profiles for the just transition' in South Africa

Growing global concern over the impacts of climate change, attributable largely to fossil fuel energy sources, has led to the widely shared goal for a 'just transition' to cleaner energy and reduced dependence on carbon-based fuels. As the world's 14th biggest CO2 emitter and being particularly vulnerable to the impacts of climate change, South Africa must embark on a just transition pathway. This paper reviews expected coal mine closures and associated community vulnerabilities and local governance challenges in South Africa. Decommissioning schedules for all coal-fired power stations and operating coal mines are plotted, and 69 mining host communities and 21 municipalities are mapped, classified, and described. Community socio-economic profiles are measured using a set of SDG indicators and census data and municipalities assessed through financial audits. Our research shows that five coal-fired power plants (8.9 GW) and 15 coal mines (29.5 Mt/a) willprobably close by 2030, and a further four plants (14 GW) and 23 mines (106 Mt/a) by 2040. Thus, the shift to cleaner energy will likely occur without the premature closures implied by the just transition. The impact of mine closure on the 2.5 million residents of host communities will be significant, particularly as levels of income, employment, and education are already very low and many municipalities are in financial distress. The South African approach to the just transition needs to take local realities into account and the narrative must support an effective transition that does not undermine energy security and economic growth. Keywords: just transition, South Africa, coal mining, mining communities, energy, mine closure

Jeff Hornibrook, A Great Undertaking: Mechanization and Social Change in a Late Imperial Chinese Coalmining Community

Jeff Hornibrook, A Great Undertaking: Mechanization and Social Change in a Late Imperial Chinese Coalmining Community

Coal's legacy in Appalachia

Appalachian coal mining provided the lifeblood of energy for a century of expanding industrial development in America. Now, coal production in Appalachia has declined to levels not seen since the late 1800s. Coal's legacy is stamped on Appalachia's mined landscapes and remains imprinted on Appalachia's coal-mining communities, and these impacts will influence land, water, and people into the 21st century, environmentally as well as economically and socially. We call on local, state and national leaders to recognize the challenges ahead for Appalachia's coal-producing communities and people; to promote economic development, education, and health in these areas; and to encourage greater chances for expansion of economic opportunities and quality of life for residents.

The shadow of the Pithead: Understanding social and political attitudes in former coal mining communities in the UK

The economic plight and consequent social and political attitudes of ‘left behind’ communities have become subjects of intense focus across a world impacted by inequality, social unrest, and political populism. We examine whether particular types of local long-term economic decline affect how residents in different places view the world; here in former mining communities of the UK which remain economically peripheral, and are home to community narratives that emphasise the shared economic, political and cultural heritages that are often fundamental to those places' very existence. We use data from the UK Household Longitudinal Study to contrast political views and social attitudes in communities that were (in 1981) economically dependent on coal mining with other communities that are similarly economically peripheral in contexts and challenges, but without a shared history of economic decline. We find that residents of former coalmining communities are highly politically disengaged, with low levels of trust and political efficacy, and low involvement in the political process. Moreover, our analysis shows an increase in political engagement over the EU referendum campaign period, which directly addressed some of the grievances felt by these communities. We conclude that community narratives of economic peripherality are strongly inter-linked with trust in government and political engagement.

Meningococcal Meningitis and Coal Mining in Provincial England: Geographical Perspectives on a Major Epidemic, 1929–33

This article presents the first systematic study of the spatial transmission of the 1929–33 epidemic of meningococcal meningitis and its association with local coal mining communities in three adjacent high incidence counties of England; Nottinghamshire, Derbyshire, and the West Riding of Yorkshire. Drawing on a robust method of spatial epidemiological analysis (swash‐backwash model), we demonstrate a gradient response with local levels of employment in coal mining for each of three key parameters of the epidemic wave: spatial velocity of transmission; duration of infectivity; and spatial reach. Partial least squares regression analysis identifies the relatively young and fertile demographic of local mining communities as the principal determinant of the resulting epidemic burden. Other sociodemographic parameters, including established risk factors for invasive meningococcal disease (low social class, high residential density, and overcrowding) are found to play little, or no, role in the spatial distribution of the disease. Our findings have importance for understanding the historic links between the coal mining industry and epidemic meningococcal meningitis, and point to possible present‐day opportunities for intervention through the designation of coal mining communities as defined risk groups for meningococcal vaccines.

The inverse care law in the Anthropocene epoch

Julian Tudor Hart described the inverse relationship between the need for effective health care and its provision in compelling terms. During his career in primary care in a former coal mining community in south Wales, UK, he showed how, by integrating clinical care with an epidemiological approach, much can be done to improve health in disadvantaged populations. 1 Hart JT Thomas C Gibbons B et al. Twenty five years of case finding and audit in a socially deprived community. Br Med J. 1991; 302: 1509-1513 Crossref PubMed Scopus (53) Google Scholar He wrote the inverse care law 2 Hart JT The inverse care law. Lancet. 1971; 1: 405-412 Summary PubMed Scopus (2006) Google Scholar based on an analysis of the UK National Health Service (NHS) 50 years ago and yet its importance has transcended that historical period and its national context. The key messages of his landmark paper 2 Hart JT The inverse care law. Lancet. 1971; 1: 405-412 Summary PubMed Scopus (2006) Google Scholar apply within many countries and on a global scale, as reviewed in The Lancet by Richard Cookson and colleagues. 3 Cookson R Doran T Asaria M Gupta I Parra Mujica F The inverse care law re-examined: a global perspective. Lancet. 2021; 397: 828-838 Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar The insights from the inverse care law and from Tudor Hart's legacy of critical thinking about health care and the political economy of health can guide us today as we navigate the challenges of the Anthropocene epoch. In the Anthropocene, humanity has a dominant role in driving environmental changes as a result of accelerating demands for energy, food, water, infrastructure, and consumer products. 4 Whitmee S Haines A Beyrer C et al. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation–Lancet Commission on planetary health. Lancet. 2015; 386: 1973-2028 Summary Full Text Full Text PDF PubMed Scopus (921) Google Scholar 50 years of the inverse care law“The availability of good medical care tends to vary with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.” Full-Text PDF The inverse care law and the potential of primary care in deprived areasThe inverse care law, whereby health care favours more assertive interests and in doing so compounds the disadvantage of patients and communities with the poorest health,1 exists in most health systems. 50 years after Julian Tudor Hart's landmark paper in which he first described the inverse care law in England and Wales,1 it is still going strong.2,3 In The Lancet, Richard Cookson and colleagues4 provide a global re-examination of the inverse care law. Full-Text PDF The inverse care law re-examined: a global perspectiveAn inverse care law persists in almost all low-income and middle-income countries, whereby socially disadvantaged people receive less, and lower-quality, health care despite having greater need. By contrast, a disproportionate care law persists in high-income countries, whereby socially disadvantaged people receive more health care, but of worse quality and insufficient quantity to meet their additional needs. Both laws are caused not only by financial barriers and fragmented health insurance systems but also by social inequalities in care seeking and co-investment as well as the costs and benefits of health care. Full-Text PDF

Julian Tudor Hart: medical pioneer and social advocate

Julian Tudor Hart is seen variously as a researcher, an expert on high blood pressure, an epidemiologist, scientist, writer, political commentator, and social advocate. But at heart he was always a practising family doctor. Few physicians manage to be expert in so many fields and none while also looking after the primary care needs of some 2100 people, which Tudor Hart did at Glyncorrwg, a former colliery village in south Wales, UK. His dedication to general practice meant his work was relevant and valued by fellow general practitioners (GPs). Tudor Hart's big idea was that a GP working “on a defined section of a world front in the war against misery and disease” could improve the health of a local population; general practice in the UK's National Health Service (NHS), with registered patient lists and no financial barriers, provided the opportunity. The inverse care law re-examined: a global perspectiveAn inverse care law persists in almost all low-income and middle-income countries, whereby socially disadvantaged people receive less, and lower-quality, health care despite having greater need. By contrast, a disproportionate care law persists in high-income countries, whereby socially disadvantaged people receive more health care, but of worse quality and insufficient quantity to meet their additional needs. Both laws are caused not only by financial barriers and fragmented health insurance systems but also by social inequalities in care seeking and co-investment as well as the costs and benefits of health care. Full-Text PDF The inverse care law and the potential of primary care in deprived areasThe inverse care law, whereby health care favours more assertive interests and in doing so compounds the disadvantage of patients and communities with the poorest health,1 exists in most health systems. 50 years after Julian Tudor Hart's landmark paper in which he first described the inverse care law in England and Wales,1 it is still going strong.2,3 In The Lancet, Richard Cookson and colleagues4 provide a global re-examination of the inverse care law. Full-Text PDF The inverse care law in the Anthropocene epochJulian Tudor Hart described the inverse relationship between the need for effective health care and its provision in compelling terms. During his career in primary care in a former coal mining community in south Wales, UK, he showed how, by integrating clinical care with an epidemiological approach, much can be done to improve health in disadvantaged populations.1 He wrote the inverse care law2 based on an analysis of the UK National Health Service (NHS) 50 years ago and yet its importance has transcended that historical period and its national context. Full-Text PDF 50 years of the inverse care law“The availability of good medical care tends to vary with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.” Full-Text PDF

The inverse care law and the potential of primary care in deprived areas

The inverse care law, whereby health care favours more assertive interests and in doing so compounds the disadvantage of patients and communities with the poorest health, 1 Hart JT The inverse care law. Lancet. 1971; 1: 405-412 Summary PubMed Scopus (2006) Google Scholar exists in most health systems. 50 years after Julian Tudor Hart's landmark paper in which he first described the inverse care law in England and Wales, 1 Hart JT The inverse care law. Lancet. 1971; 1: 405-412 Summary PubMed Scopus (2006) Google Scholar it is still going strong. 2 Fisher R Dunn P Asaria M et al. Briefing: level or not? Comparing general practice in areas of high and low socioeconomic deprivation in England. Health Foundation, London2020 Google Scholar , 3 Gopfert A Deeny SR Fisher R Stafford M Primary care consultation length by deprivation and multimorbidity in England: an observational study using electronic patient records. Br J Gen Pract. 2020; (published online Dec 14.)https://doi.org/10.3399/bjgp20X714029 Crossref PubMed Scopus (7) Google Scholar In The Lancet, Richard Cookson and colleagues 4 Cookson R Doran T Asaria M Gupta I Parra Mujica F The inverse care law re-examined: a global perspective. Lancet. 2021; 397: 828-838 Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar provide a global re-examination of the inverse care law. 50 years of the inverse care law“The availability of good medical care tends to vary with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.” Full-Text PDF The inverse care law in the Anthropocene epochJulian Tudor Hart described the inverse relationship between the need for effective health care and its provision in compelling terms. During his career in primary care in a former coal mining community in south Wales, UK, he showed how, by integrating clinical care with an epidemiological approach, much can be done to improve health in disadvantaged populations.1 He wrote the inverse care law2 based on an analysis of the UK National Health Service (NHS) 50 years ago and yet its importance has transcended that historical period and its national context. Full-Text PDF The inverse care law re-examined: a global perspectiveAn inverse care law persists in almost all low-income and middle-income countries, whereby socially disadvantaged people receive less, and lower-quality, health care despite having greater need. By contrast, a disproportionate care law persists in high-income countries, whereby socially disadvantaged people receive more health care, but of worse quality and insufficient quantity to meet their additional needs. Both laws are caused not only by financial barriers and fragmented health insurance systems but also by social inequalities in care seeking and co-investment as well as the costs and benefits of health care. Full-Text PDF