That photograph suggests an improvement on a Viet Nam war-era bumper sticker:
MOTHER EARTH: LOVE HER OR LEAVE HER!
Never, if by "recognise" is meant "do something substantive to fix it".
After all, they brought it on themselves by choosing that employment. And they brought it on their kids by not choosing Abstinence.
As usual when it comes to articles about MTR, the presence of no comments (on-topic ones) speaks volumes. It seem that nobody cares about the destruction of West Virginia and Eastern Kentucky becasue they are in the unfashionable "east".