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This study examines the relationship between depression symptoms and living in areas where mountaintop removal coal mining is practiced. Data were analyzed from a survey of 8,591 adults residing in Central Appalachian areas both with and without coal mining. The survey included a validated measure of depression severity. Results showed that diagnosable levels of major depression were present in almost 17% of respondents in mountaintop removal mining areas, compared to 10% of residents indoi:10.1089/eco.2013.0029 fatcat:kstgxfofnvaoxpowgobgt7stxe