Fractured from Fracking: Examining the Health and Wellbeing
Implications of Unconventional Natural Gas Development in
Rural Communities
vorgelegt von
M. Sc
Fiona Mactaggart
ORCID: 0000-0003-1865-7118
an der Fakultät VII – Wirtschaft und Management
der Technischen Universität Berlin
zur Erlangung des akademischen Grades
Doktor der Gesundheitswissenschaften/Public Health
- Dr. P.H. -
genehmigte Dissertation
Promotionsausschuss:
Vorsitzender: Dr. Wilm Quentin
Gutachter: Prof. Dr. Reinhard Busse
Gutachter: Prof. Dr. Christian Gericke
Tag der wissenschaftlichen Aussprache: 22. März 2021
Berlin 2021
2!
Table of Contents
List of Figures! 4!
List of Tables! 5!
Acknowledgements! 6!
Abbreviations! 7!
Summary! 8!
Background! 8!
Objectives! 9!
Results! 9!
Systematically Reviewing the Evidence! 9!
Assessing Health Needs in a Mining Community!10!
Understanding Local Health Systems!10!
Defining Relationships Between the Health and Mining Sector!11!
Conclusion!11!
Zusammenfassung!13!
Hintergrund!13!
Ziele!14!
Methoden!14!
Ergebnisse!15!
Fazit!16!
1. Introduction 18!
1.1 Background 18!
1.2 Aim and Objectives 21!
1.3 Scope of Thesis 21!
1.4 Thesis Structure 22!
1.5 Methodological Background 23!
1.5.1 Part One!24!
1.5.2 Part Two!24!
1.5.3 Part Three!25!
Part I: Reviewing the available evidence for an association between health and wellbeing
and mining activity!27!
2. Examining health and wellbeing outcomes associated with mining activity in rural
communities of high-income countries: A systematic review 28!
3. Exploring the broader health and wellbeing outcomes of mining communities in low
and middle-income countries: A systematic review 37!
Part II: Examining health and wellbeing outcomes in Coal Seam Gas mine settings!54!
3!
4: Exploring the determinants of health and wellbeing in communities living in proximity
to coal seam gas developments in regional Queensland!55!
Part III: Examining regional health systems within which the Coal Seam Gas industry
interacts!69!
5: Community, climate, economics and geography: understanding rural health systems
through the lens of systems theory!70!
6: How does the Coal Seam Gas industry interact with the health system in regional
Queensland, Australia? Perceptions of service providers!
97!
120!
120!
120!
124!
125!
130!
131!
135!
135!
136!
139!
141!
7. Discussion
7.1 Overview of this Chapter
7.2 Key Themes Identified in this Thesis
7.3 Summary of Key Findings
7.4 Recommendations and Suggestions for Further Research
8. Conclusion
9. References
10. Appendices
10.1 Search strategies for Chapters 2 and 3
10.2 Qualitative Research: Key Informant Interview Guides
10.3 Qualitative Research: In-depth Interview Guides
10.4 Qualitative Research: Focus Group Discussion Interview Guides
List of Figures
Chapter 1; Figure 1. Schematic of thesis structure……………………...…………...…...…….23
Chapter 2; Figure 1. Flowchart detailing selection, screening and eligibility
process……………………………………………………………………………….…...…...…….31
Chapter 3; Figure 1. Flowchart detailing stages of the selection, screening & eligibility
process...................................................................................................................................42
Chapter 4; Figure 1. A simplified HNA process describing the first two stages used in this
study.......................................................................................................................................59
Chapter 4; Figure 2. The Framework Method was developed with reference to the social
determinants of health model and provided the authors with an initial structure to
systematically reduce and analyse the data..........................................................................60
Chapter 5; Figure 1. Population distribution by ARIA+ Remoteness classification by study
area….........................................................................................................................76
List of Tables
Chapter 2; Table 1. Articles included in the synthesis with an extracted summary of target
population, mining type and main outcomes……………..………………………………………..…32
Chapter 3; Table 1. Articles included in the synthesis with an extracted summary of study type,
target population, mining type and data collection method. ……………………………………..…43
Chapter 4; Table 1. Demographic and economic summaries of four study sites in regional
Queensland, 2014……………………………………………………………………………………....58
Chapter 4; Table 2. Qualitative primary research involved 45 key informant interviews with
health and community service providers; and 11focus group discussions and 19 individual in-
depth interviews with community members across the four study sites………………..…………60
Chapter 4; Table 3. Summary of key findings and recommendations……………………………..66
Chapter 5; Table 1. Features of complex adaptive systems….…………………………………....74
Chapter 5; Table 2. Profile of study sites……………………………………………………….........77
Chapter 5; Table 3. Summary of type of service and number of participants by area…………...78
Chapter 6; Table 1. 2014 demographic and economic summaries of four study sites in regional
Queensland……………………………………………………………………………………………..102
Chapter 6; Table 2. Qualitative primary research involved 45 key informant interviews with
health and community service providers across the four study sites..…………………………...103
Loading more pages...