Chris Dorst, Charleston, WV Gazette.
According to Mortality Rates in Appalachian Coal Mining Counties: 24 Years Behind the Nation, by Michael Hendryx, of the Department of Community Medicine, West Virginia University, Morgantown, WV <pdf>, mortality is 10.21 % higher in Appalachia than elsewhere in the US, and 18.45 % higher in in coal mining counties where 4 million tons or more of coal are mined. (See also Coal Tattoo.)
Part of the problem is poverty, lack of education, smoking, and other factors, but these are all related to the coal economy.