This report examines the mortality rates in Appalachian coal mining communities using the Iceberg model, a system-thinking tool. It identifies key events, such as the increasing mortality rate, particularly from lung cancer, cardiovascular diseases, and respiratory illnesses, compared to non-Appalachian areas. The report presents statistical data and graphs illustrating the high incidence of cancer, lung cancer, respiratory diseases, heart attacks, and cardiovascular diseases in the region. It also analyzes patterns, including the decline in health issues and fatal coal mining accidents over time, suggesting improvements in governmental approaches. The conclusion emphasizes the environmental complexity of coal-producing regions as a factor in increased mortality, highlighting various health and morbidity causes in these communities.