دیدگاه در مورد مسائل سلامت و بهداشت جامعه و چرخه رونق _ رکود معدن

The health of mining communities is becoming a priority for the mining industry, governments, and researchers. This paper describes an exploratory qualitative study into community health issues and mining activities (associated with the mining boom–bust cycle) from the perspective of health and social service providers in the northern Canadian coal mining community of Tumbler Ridge, British Columbia. Health and social service providers report on increases in pregnancies, sexually transmitted infections, and mine related injuries during booming mine activities. During bust times, mental health issues such as depression and anxiety were reported. Overarching community health issues prominent during both boom and bust periods include burdens to health and social services, family stress, violence towards women, and addiction issues. This paper concludes by providing recommendations as to how the industry can enhance community health made by this important stakeholder group.

Today, governments, non-governmental organizations, communities, and mining organizations expect mining companies to plan for and mitigate health impacts associated with development projects. The mining sector has recognized the importance of health, and has made specific commitments to enhancing the health of associated communities. For instance, the International Council on Mining and Metals (ICMM) identifies in their sustainable development framework that corporate members are committed to implement and measure their performance against ten principals. Under Principal 5: Seek continued improvement of our health and safety, the ICMM includes implementing “a management system focused on continual improvement of all aspects of operations that could have a significant impact on the health and safety of our own employees, those of contractors and the communities where we operate” ( International Council on Mining and Metals, 2008, p.10). These commitments recognize that “beyond work related diseases, few endeavours attempt to prevent diseases that affect the wider community or to consider the community's broader well-being” ( Mining, 2002); and that “Ensuring that improved health and education or economic activity will endure after mines close requires a level of planning that has too often not been achieved” ( Mining, 2002, p. xvii). The following section highlights literature related to community health and the mining sector as developed by international organizations over the past decade. The most comprehensive report available to date related to mining community health is the literature review of worker and community health and mining by Stephens and Ahern (2001) as part of the Mining, Minerals and Sustainable Development (MMSD) project. This review identified that mining community health research has historically focused on community exposure to environmental toxins (Stephens and Ahern, 2001). The final report of the MMSD project Breaking New Ground reports community health as an important parameter in their chapter on Local Communities and Mines ( Mining, Minerals and Sustainable Development Project, 2002, Chapter 9, p.203). However, the description of community health issues is limited to four paragraphs and lacks a detailed description of issues a mining company can/should address in sustainable development/community relations planning ( Mining, Minerals and Sustainable Development Project, 2002). In 2003, the International Finance Corporation (IFC) identified potential health impacts associated with private sector projects in emerging economies to include: changes in nutritional status, mortality and morbidity, HIV and other communicable diseases, endemic diseases, impacts of in-migration on health services and associated infrastructure, and environmental (exposure) health impacts ( International Finance Corporation, 2003, p. 12). More recently, the IFC released a guidebook to introduce the health impact assessment (HIA) procedure with main objectives of: providing guidance to associated corporations in relation to the HIA process, and assisting in assessing potential impacts to community health as a result of project development. However, the HIA process as outlined by the IFC is limited to environmental health areas, and does not mention health issues associated with other determinants of health ( International Finance Corporation, 2009). Although nutritional status, communicable diseases such as HIV, and illness stemming from exposure to environmental toxins have been highlighted as important issues for the mining industry to consider, plan for, and mitigate, today the mining sector is engaged in directives that commit to sustainable development and corporate social responsibility. These commitments require the industry to update the concept of community health, and to incorporate this consideration into mine planning. The World Health Organization (WHO) defines health as “a state of complete physical and mental and social well being and not purely the presence or absence of disease” (World Health Organization, 1948, p. 100) and “the extent to which an individual or a group is able, on the one hand, to realize aspirations and to satisfy needs, and on the other, to change or cope with the environment” (World Health Organization, 1986, p. 1). Recently, the mining sector published an important document regarding the health of communities: the International Council on Mining and Metals (ICMM) Good Practice Guidance on Health Impact Assessment (International Council on Mining and Metals, 2010). This guidebook represents the first reference material produced by the mining sector that describes health beyond the presence and absence of disease or environmental exposures, and includes other factors that impact health (International Council on Mining and Metals, 2010). Commonly referred to as determinants of health, these factors can include: income and social status, social support networks, education, employment and working conditions, social environments, physical environments, personal health practices and coping skills, healthy child development, biology and genetic endowment, health services, gender, and culture (Health Canada, 2004). To pursue this momentum within the mining sector, to contribute to industries' efforts to enhance the health of associated communities, and to investigate if communities are benefiting from mining sector community health-specific commitments and guidance frameworks, this paper presents an exploratory qualitative investigation into community health issues and mining activities from the perspective of health and social service providers in a remote Canadian coal mining community. Health and social service providers were chosen to participate in this study for two reasons: (1) health care providers have been recognized as important contributors to health status, and play an important role in shaping the health of a community (Health Canada, 2004), and (2) in order to gain a holistic view of how mining has affected community health, it is important to include perspectives from community residents who have experience with certain social determinants of health (gender, age, income, and education). This paper is organized as follows. First, the Canadian/British Columbia (BC) mining context is briefly described with a focus on the commitment made to communities. The next section provides a socio-economic description of the study community; Tumbler Ridge, BC. This is followed by a detailed explanation of the study's method including data collection and analysis, and then presentation of main findings. The final section discusses the results and highlights policy implications for the mining sector, governments, and researchers.

In conclusion, this study took place in a northern Canadian community that was developed purposefully to support coal mining, and focused on how health and social service providers perceive the mining boom–bust cycle to affect community health. This paper reports on the perceptions that the mining boom–bust cycle has negatively impacted health outcomes for the residents of this community. This paper also reports on recommendations from health and social service providers to enhance the health of this community. Specifically, the mining industry at large, com- munity planners, impact assessors, and policy makers should according to the interviewees focus on: the provision of family counseling services to mitigate negative impacts to family struc- tures resultant from current mining shift rotation schedules; ensuring women have access to appropriate health care services (such as transition housing and maternity care) and opportunities for important determinant of health issues (such as employment and child care options); enhancing drug and alcohol policies and support services at the mine site and in the community at large; increasing safety training opportunities for miners and ensuring adequate rehabilitation services are available in case of injury; and guaranteeing a company’s presence is not overburdening important health services taking an active role in participating in community health provision (through funding health services) and by collaborating with the appropriate government authorities to ensure adequate funding has been allocated to support the increased demand on health and service delivery. Consideration of these issues is important, as this study suggests that commit- ments made by the industry and governments to communities are, at least in the case of Tumbler Ridge, BC, falling short.