Spatial Analysis of Healthcare Utilization Among Medicare Beneficiaries With Coal Workers' Pneumoconiosis and Other Related Pneumoconiosis


Seventy percent of U.S. coal is produced in five states: Wyoming, West Virginia, Kentucky, Illinois, and Pennsylvania. In 2017 there were approximately 50,000 coal miners, more than half of whom worked in just 25 mostly rural counties spread across 9 states. These miners are at risk of developing respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD), asbestosis, silicosis, and coal workers' pneumoconiosis (CWP), also referred to as black lung disease. CWP is a progressive occupational lung disease caused by overexposure to respirable coal mine dust and there is no cure. The Federal Coal Mine Health and Safety Act of 1969 outlined practices to improve the health of all individuals working in underground coal mines, and since 1979 coal workers have access to care, education, and counseling at Black Lung Clinics.

There is little information available on geographical distribution and spatial clustering of healthcare utilization among Medicare beneficiaries with CWP and other related pneumoconiosis. The aims of this project were to determine and map the geographical distribution of healthcare utilization patterns among Medicare beneficiaries with CWP and other related pneumoconiosis using the Medicare beneficiaries Limited Data Set from 2011-2014 and conduct spatial analysis of healthcare utilization among Medicare beneficiaries with CWP and other related pneumoconiosis.

The study found significantly elevated rates of healthcare utilization for Medicare beneficiaries with CWP from 2011 to 2014 in counties in the central Appalachian states (West Virginia, Kentucky, and Virginia) compared to other parts of the country. These findings signify the need for expanding access to health care for individuals with CWP. However, the significance of clusters of healthcare utilization rates among beneficiaries with other related pneumoconiosis is unknown, and there is a need for further studies to understand the characteristics of these beneficiaries and the underlying disease etiology.

Rural and Underserved Health Research Center
Ahmed Arif, Claudio Owusu, Rajib Paul, Christopher Blanchette, Ripsi Patel, Tyrone Borders