This dissertation uses mixed methods to examine the role of the coal industry in the reproduction of Central Appalachia as an internal periphery within the United States and the economic, ecological, and human inequalities this entails. It also analyzes the related political economy and power structure of coal in a national context. Particularly important for analysis of the region's underdevelopment are the class relations involved in unequal ecological exchange and the establishment of successive "modes of extraction." I employ a historical comparative analysis of Appalachia to evaluate Bunker's thesis that resource dependent peripheries often become locked into a "mode of extraction" (with aspects parallel to Marxist concepts of mode of production) triggering economic and ecological path dependencies leading to underdevelopment. This historical comparative analysis establishes the background for a closer examination of the political economy of the modern US coal industry. After sketching the changes in the structure of monopoly and competition in the coal industry I employ network analysis of the directorate interlocks of the top twenty coal firms in the US within the larger energy policy-planning network to examine their connections with key institutions of the policy formation network of think tanks and business groups. My findings show the importance of the capacities of fossil fuel fractions of the capitalist class in formulating energy policy around issues such as the 2009 climate legislation. As a contribution to the growing literature applying the concept of metabolism as link between contemporary and classical theory, I examine the conflict at Coal River Mountain from the vantage points of ecology, political economy, and human development in dialectical rotation. Utilizing Marx's method of successive abstractions, the mountain is presented as a nexus of metabolic rifts in the human relationship to the earth's natural systems and an impediment to genuine human development. Finally, I conclude with some implications of this analysis for building a critical environmental sociology of extractive economies. This dissertation includes previously published materials. / 2016-09-29