Hillary Clinton’s pitch to voters in Appalachia fell flat this week, and she is in real danger of losing the West Virginia primary to Sen. Bernard Sanders next week — but analysts say the former first lady has deeper problems in coal country that could spill into the general election.

Mrs. Clinton has shifted positions on coal over the past eight years, moving from high praise for clean-coal technology and the fuel’s role in U.S. energy production in 2008 to guaranteeing miners will be out of work and coal mines shut down if she is elected to the White House in November. Although she has tried to distance herself from those inflammatory statements and salvage her campaign in the pro-coal territory of West Virginia, Kentucky and elsewhere, political analysts say there is little Mrs. Clinton can do to repair the damage.

Attempts to appeal to blue-collar workers in Appalachia and possibly snatch those states from the Republican column in November look futile.

“Yes, this is a different Clinton on fossil fuels than in 2008. She did quite well with white working-class voters in those parts of Appalachia in 2008. But she has not been making her appeals to coal country. Her recent statements on climate change have given her some problems. It did not go well for her in [Kentucky and West Virginia] over the past few days. In general, the Democrats are going to have electoral difficulties in those regions,” said G. Terry Madonna, a Pennsylvania pollster and professor of public affairs at Lancaster’s Franklin & Marshall College.

Mrs. Clinton spent Monday and Tuesday in West Virginia and Kentucky in an attempt to smooth over a strained relationship with blue-collar workers, particularly those in the coal industry. Mrs. Clinton said earlier this year that more miners would be put out of work if she is elected president and vowed to continue President Obama’s unprecedented crackdown on carbon emissions through federal regulation.

The former secretary of state then tried to retract her comments by saying she was merely opining on the fact that the U.S. coal industry is declining.

“I don’t know how to explain it other than what I said was totally out of context from what I meant because I have been talking about helping coal country for a very long time, and I did put out a plan last summer,” she said. “I didn’t mean that we were going to do it. What I said was that is going to happen unless we take action to try to help and prevent it,” Mrs. Clinton said at a town hall meeting in West Virginia this week.

But Mrs. Clinton’s words appear to ring hollow, even among voters in her own party. In West Virginia, where Democrats will vote in the party’s presidential primary next week, Mrs. Clinton is trailing Mr. Sanders.

Mr. Sanders was in West Virginia for two rallies, one in Charleston and another in Morgantown.

A Public Policy Polling survey released this week shows Mr. Sanders up by 8 percentage points — a stunning turnaround for Mrs. Clinton, who dominated blue-collar voters in West Virginia and other states in her 2008 primary matchup with Barack Obama.

In that race, Mrs. Clinton spoke favorably of coal, whose share of American power generation has fallen dramatically under the Obama administration.

“The political pressure [to use coal] will remain intense, and I think you have got to admit that coal, of which we have a great and abundant supply in America, is not going away. So how do we best manage the possibility of using clean coal, but having very strict environmental standards? It is not going to do us any good if we substitute one dirty energy source for another,” Mrs. Clinton said in 2007.

Now, in the face of a tough primary challenge from Mr. Sanders, who has made climate change and a move away from fossil fuels key issues in his campaign, the former first lady has changed her tune.

It’s unclear exactly how the issue will play out in a general election. The Republican presidential nominee — now sure to be billionaire businessman Donald Trump — likely would win the traditionally red states of West Virginia and Kentucky anyway.

But the issue also could come into play in battleground coal states such as Pennsylvania and Virginia. Mr. Trump has said he could carry those states with a message that appeals to working-class voters, a point he underlined at a rally Thursday evening.

Speaking at the Charleston Civic Center in West Virginia, Mr. Trump briefly donned a coal miner’s hat and told the crowd that he would revive the coal industry and Mrs. Clinton would kill it.

“I am going to put the miners back to work, and she said, ‘I am going to put the miners and the mines out of business,’” Mr. Trump said, alluding to the comments Mrs. Clinton made at a March town hall event.

“We are going to open the mines,” Mr. Trump said. “If I win, we are going to bring those miners back. You are going to be so proud of your president, you are going to be so proud of your country.”

Coal advocates have made clear that they intend to keep the pressure on Mrs. Clinton as the general election campaign unfolds.

“Clinton has made it very clear that she would be a virtual Obama 2.0, backing regulations that would stunt economic growth and hurt those who can least afford it the most,” said Laura Sheehan, senior vice president of communications for the American Coalition for Clean Coal Electricity. “We can only hope that as this election cycle continues and Secretary Clinton meets firsthand with those she proposes to put out of work, that she takes a step back and asks herself if the cost of Obama’s illegal carbon regulations, which will have no meaningful effect on global climate change, are worth the risk to everyday hardworking Americans struggling to make ends meet.”

• Seth McLaughlin contributed to this report.

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