Having lived in the area for 20+ years, it is just as bad and possibly worse than any picture can illustrate. Nice, sulfur smell everywhere... similar to the imagined smell-o-Hell. Horrible fog/steam anytime there is moisture added to the area.
And yes, there are stubborn SOBs that refused to take the state/Fed money to leave and still live there. It is not very good for your health, either. But then, many places in central PA aren't... coal particulates in the air.
So, you wanna freaky experience? Take the Minersville exit off of Rt. 81 anytime you are traveling in PA. Head West on 901and find Route 61. Hey, if you are near Shamokin (my birthplace and home for 21 years), stop by and have a burger at the Coney Island. Please take a spare set of clothes, because you will need to incinerate the set that you wear into the joint. No joke.