Remote Sensing of Forest Structural Changes Due to the Recent Boom of Unconventional Shale Gas Extraction Activities in Appalachian Ohio

Dense unconventional shale gas extraction activities have occurred in Appalachian Ohio since 2010 and they have caused various landcover changes and forest fragmentation issues. This research investigated the most recent boom of unconventional shale gas extraction activities and their impacts on the landcover changes and forest structural changes in the Muskingum River Watershed in Appalachian Ohio. Triple-temporal high-resolution natural-color aerial images from 2006 to 2017 and a group of ancillary geographic information system (GIS) data were first used to digitize the landcover changes due to the recent boom of these unconventional shale gas extraction activities. Geographic object-based image analysis (GEOBIA) was then employed to form forest patches as image objects and to accurately quantify the forest connectivity. Lastly, the initial and updated forest image objects were used to quantify the loss of core forest as the two-dimensional (2D) forest structural changes, and initial and updated canopy height models (CHMs) derived from airborne light detection and ranging (LiDAR) point clouds were used to quantify the loss of forest volume as three-dimensional (3D) forest structural changes. The results indicate a consistent format but uneven spatiotemporal development of these unconventional shale gas extraction activities. Dense unconventional shale gas extraction activities formed two apparent hotspots. Two-thirds of the well pad facilities and half of the pipeline right-of-way (ROW) corridors were constructed during the raising phase of the boom. At the end of the boom, significant forest fragmentation already occurred in both hotspots of these active unconventional shale gas extraction activities, and the areal loss of core forest reached up to 14.60% in the densest concentrated regions of these activities. These results call for attention to the ecological studies targeted on the forest fragmentation in the Muskingum River Watershed and the broader Appalachian Ohio regions.

Diabetes in Appalachia: providers’ perspectives

Background: Southeastern Appalachian Ohio has more than double the national average of diabetes and a critical shortage of healthcare providers. Paradoxically, there is limited research focused on primary care providers’ experiences treating people with diabetes in this region. This study explored providers’ perceived barriers to and facilitators for treating patients with diabetes in southeastern Appalachian Ohio. Methods: We conducted in-depth interviews with healthcare providers who treat people with diabetes in rural southeastern Ohio. Interviews were transcribed, coded, and analyzed via content and thematic analyses using NVivo 12 software (QSR International, Chadstone, VIC, Australia). Results: Qualitative analysis revealed four themes: (1) patients’ diabetes fatalism and helplessness: providers recounted story after story of patients believing that their diabetes was inevitable and that they were helpless to prevent or delay diabetes complications. (2) Comorbid psychosocial issues: providers described high rates of depression, anxiety, incest, abuse, and post-traumatic stress disorder among people with diabetes in this region. (3) Inter-connected social determinants interfering with diabetes care: providers identified major barriers including lack of access to providers, lack of access to transportation, food insecurity, housing insecurity, and financial insecurity. (4) Providers’ cultural understanding and recommendations: providers emphasized the importance of understanding of the values central to Appalachian culture and gave culturally attuned clinical suggestions for how to use these values when working with this population. Conclusions: Evidence-based interventions tailored to Appalachian culture and training designed to increase the cultural competency and cultural humility of primary care providers may be effective approaches to reduce barriers to diabetes care in Appalachian Ohio.