On April 16, 2026, the U.S. Senate voted 50-49 along partisan lines to revoke a 20-year mining ban protecting more than 225,000 acres of Superior National Forest land in the Boundary Waters Canoe Area Wilderness watershed. The vote clears the path for Twin Metals, a subsidiary of Chilean mining giant Antofagasta, to reapply for permits to open an underground copper mine near Ely.
For Minnesota’s family physicians, this is not just an environmental story. It is a public health story.
MAFP Urges Mandatory Health Impact Assessments
Earlier this spring, the Minnesota Academy of Family Physicians (MAFP) sent letters to the Minnesota Environmental Quality Board (EQB), state legislators, commissioners and environmental working groups, calling on the state to require health impact assessments (HIAs) as part of all environmental reviews.
The MAFP’s specific requests included:
- Requiring a comprehensive, independent HIA for any project that triggers an Environmental Impact Statement (EIS).
- Revising Minnesota’s environmental assessment worksheet to explicitly address human health impacts.
- Funding HIAs as a required component of environmental review.
- Ensuring the Minnesota Department of Health has resources to support Tribal Nations and local communities through the process.
Why an EIS Alone Is Not Enough
An EIS may model how much mercury enters a watershed. It does not answer what happens when that mercury accumulates in fish that families and Tribal members eat.
The documented risks of sulfide-ore mining are serious. They include methylmercury contamination of fish, exposure to lead, manganese and arsenic, and carcinogenic air emissions from nickel, crystalline fibers and other particulates. A 2011 Minnesota Department of Health study found 1 in 10 newborns in Minnesota’s Lake Superior basin had elevated blood mercury levels. Medical research consistently links heavy metal exposure to neurodevelopment disorders, cancers, and heart and lung disease. Children and unborn fetuses bear the greatest risk.
An HIA fills the gap an EIS cannot. It provides a systematic, science-based evaluation of how a proposed project would affect surrounding populations, including workers, nearby residents and Tribal members who rely on fishing, hunting and gathering.
A Decade of Physician Advocacy
The MAFP’s push for HIAs is not new. It has been building for nearly a decade, driven by physician leaders and formal policy action.
- 2017: A resolution was adopted directing the MAFP to support HIAs for all Minnesota projects requiring an environmental assessment worksheet or Environmental Impact Statement.
- Since then: MAFP members have been central to this advocacy, meeting directly with EQB members alongside MAFP leadership to make the case for health-centered environmental review.
- Broad coalition: The MAFP has partnered with the Minnesota Medical Association, Minnesota Public Health Association and Minnesota Nurses Association to advocate for human health to be included in environmental review.
- Beyond mining: The MAFP has also called for health equity impact assessments in health care decisions that impact communities.
Calls for Action and Education
With the federal mining ban now revoked, state-level protections matter more than ever. Family physicians have a critical role to play in their communities, in their clinics and at the Capitol.
Members who attended the recent Spring Refresher heard directly from Emily Onello, MD, an MAFP member and faculty member at the University of Minnesota Medical School, Duluth campus, who has contributed to publications on the health impacts of copper-sulfide mining. Onello emphasized that family physicians are well positioned to recognize, address and communicate health concerns related to sulfide mining in their communities. View her presentation slides.
- Contact your legislators to urge support for requiring Health Impact Assessments.
- Connect with the MAFP to share your experience or concerns.
- Read the letter the MAFP sent to the EQB.
- Stay informed through MAFP’s legislative updates and advocacy communications.
- Access the “Beneath the Surface: Sulfide Mining and Human Health” slides.
