Some of the poorest people in the world's poorest countries eke out a living in artisanal and small‐scale mining (ASM). Equipped with primitive tools like picks, shovels, buckets, and gold pans, they work mining valuable resources, like gold, diamonds, tin, lithium, rare earth elements, tantalum, and cobalt, and any other usable commodity, for example, sand, coal, or mica. The mining and refining processes are labor intensive and associated with a variety of health problems due to accidents, overheating, overexertion, dust inhalation, exposure to toxic chemicals and gases, violence, and illicit and prescription drug and alcohol addiction. Evident disadvantages with ASM are counterbalanced by the immense economic benefits. For many, the true scope and scale of ASM activities are unappreciated, along with the unknown health and societal impacts. Here, we set out to elucidate the scope of ASM beyond the recovery of familiar commodities, such as gold and diamonds. We adopt a holistic perspective toward health impacts of ASM, which includes unique occupational, environmental, and human/social drivers. A particular focus is poverty as a health risk with artisanal miners. They are commonly poverty‐stricken people in poor countries, ensnared by a variety of poverty traps, which take a toll on the health and well‐being of individuals and communities. ASM sometimes provides an opportunity to diversify income in the face of a decline in subsistence agriculture. However, ASM often trades one kind of generational poverty for another, coming along with serious health risks and turmoil associated with work in an informal “cash‐rich” business.

This review examines health issues around human/social determinants of health within artisanal and small‐scale mining (ASM). The focus is on working children and violence. Within the area of violence, the collection of health risks is broad, ranging from self‐directed impacts such as suicide or neglect, to interpersonal impacts such as child or intimate partner abuse, and to collective violence such as trafficking, fighting for resources and ultimately war. Discussions on such impacts are less about accidents and illnesses and more about psychological issues. We review studies shedding light on health implications of ASM for children at sites in Suriname and Democratic Republic of Congo (DRC). These studies helped to dispel the perception that the long list of hazards and health risks commonly cited are present at every mining site. Although worker and community interviews provide useful information about accidents and other common ailments, they cannot replace formal medical screenings for serious health problems. There are likely health effects related to criminality and violence. Detailed interviews from Domaine Marial, DRC, with respect to violence to children and intimate women partners are sobering. Violence has also developed with takeovers by local gangs, domestic and transnational organized criminal groups, and insurgent and terrorist groups. Human health can be negatively impacted by worsened working conditions, collateral damage due to fighting among criminal groups and violence more generally, loss of employment or displacement. The negative impacts of ASM can be reduced through policy interventions based on an understanding of what is happening in various countries.