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Do local businesses still own Main Street in Minnesota’s rural communities? Or are national chains and large corporations changing the fabric of what it means to be a small town?

That’s the question MPR News host Kerri Miller posed during her most recent Rural Voice town hall in southern Minnesota.

Coming up at 9 a.m. on Thursday, listen to a recording of that discussion, held Sept. 28 at The Broadway event center in downtown Albert Lea, Minn.

Business owners and community leaders agreed that keeping local businesses local is key to maintaining small town feel and charm. But doing that is no small feat.

Business owners say they work long hours, money is always tight and even if the business is a success, figuring out how to grow sustainably is a challenge.

Organizations designed to support local businesses, like the Southern Minnesota Initiative Foundation, say it’s a story they hear a lot. They pointed to the critical role community support and innovative financing models play in sustaining rural businesses.

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For decades, the coal mining industry has been reckoning with a disease called black lung. Now a similar condition is disabling and even killing workers who cut artificial stone, for trendy quartz countertops and backsplashes. It’s called silicosis, and you get it by breathing in tiny crystals of a mineral called silica.

The nation’s largest manufacturer of artificial stone is Cambria, a company based in Minnesota. But California is the epicenter of silicosis cases in the U.S. and regulators in that state could soon ban the making of these products.

For more on what health professionals in California and around the country are seeing in silicosis patients, MPR News host Nina Moini talked with Dr. Sheiphali Gandhi. She leads the California Silicosis Support and Research Network at the University of California-San Francisco, where she is an assistant professor of medicine.

MPR News reached out to Cambria, which has faced hundreds of lawsuits related to silicosis, and has not received a response. The company has said repeatedly that it maintains safe working conditions, partly by wetting facilities to keep dust out of the air. It blames lung disease on smaller fabrication shops in the supply chain.

The Minnesota Department of Health tracks silicosis cases using hospitalization data. Cases have decreased over the last 15 years, according to a spokesperson.

“Recent events in other states have raised the profile of silicosis among public health professionals and we are working to learn more about the silicosis issue,” the spokesperson said in a statement to MPR News. “MDH will continue to monitor our data for any significant changes and will explore changes to state statute that may ease the burden of reporting on providers and ensure quality data.”

Use the audio player above to listen to the full conversation.

Subscribe to the Minnesota Now podcast on Apple Podcasts, Spotify or wherever you get your podcasts.

We attempt to make transcripts for Minnesota Now available the next business day after a broadcast. When ready they will appear here.

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Another proposed health system merger is poised to further reshape Minnesota’s healthcare industry.

Bloomington-based HealthPartners and Duluth-based Essentia Health announced Tuesday that their respective boards of directors have approved a merger plan.

If approved by regulators, the merger of the two nonprofit health systems is set to be complete by the start of next year. The new organization would take the HealthPartners name and have about 45,000 employees staffing dozens of hospitals and clinics across Minnesota, Wisconsin and North Dakota. It would be one of the largest healthcare systems in the region.

“This combination is about doing more for the people and communities who count on us,” HealthPartners President and CEO Andrea Walsh said in a statement announcing the merger.

“HealthPartners and Essentia Health share a belief that everyone deserves access to high-quality care and coverage, close to home and centered on their needs,” Walsh said. “Together, we can build on the strengths of both organizations to improve health, expand access and create a stronger future for the communities we serve.”

Essentia Health CEO Dr. David Herman said the two organizations “share similar missions and values, deep roots in this region, and a focus on improving health and well-being.”

“As a combined nonprofit health system, we will be able to better innovate and grow our workforce. That strong foundation will make us even better partners for our patients, working together to help people live their healthiest lives, wherever they call home,” Herman said in a statement.

It’s the third major proposed merger involving Minnesota health systems in 2026.

North Memorial Health and South Dakota-based Sanford Health completed a merger earlier this year.

And a proposed merger of Allina Health and California-based Sutter Health remains under review by state regulators.

Speaking with reporters Tuesday afternoon, Walsh and Herman said the merger is needed to confront challenges facing the broader healthcare sector, including rising healthcare costs and health insurance premiums, lower reimbursements, and workforce shortages.

“What we believe is HealthPartners and Essentia together, coming together, we can combine complementary strengths to improve health experience affordability and quality, and to navigate some of the industry trends that are a challenge not only in Minnesota but across the nation,” Walsh said.

“That’s what other health systems are finding — that when you have complementary capabilities, you’re stronger together,” Herman said.

Herman described the proposed merger as the two systems leading, rather than reacting, to a healthcare environment he described as “dynamic” and even “chaotic.”

“We know that while we’re strong, our patients, our communities, and our colleagues depend upon us. And coming together when we’re strong, working on things that we know are important — like access, affordability, getting your best care and your best health wherever you choose to live — are the things that are important,” he said.

HealthPartners and Essentia Health said Tuesday that they have “complementary strengths in care delivery, health plan coverage, urban and rural community health, research, medical education and innovation.”

They said the merger would give patients access to more medical expertise and specialists and give employees more career pathways within the organization.

Walsh would lead the combined organization, with Herman serving as president of combined clinical care group operations.

HealthPartners and Essentia said their patients and members should not see any changes or interruptions to health care or insurance coverage. Walsh and Herman said there are no plans to close clinics or hospitals.

For now, Essentia Health facilities will retain that branding. Herman said the plan is to convert them to the HealthPartners name at some point in the future, once the two systems are fully combined.

The Minnesota Nurses Association issued a statement saying it has “serious concerns” about the merger plan — with the union also saying its members who are employed by both health systems had no advance notice of the proposal ahead of Tuesday’s public announcement.

“Minnesota has now seen three major back-to-back healthcare consolidation announcements, and nurses are deeply concerned about what that could mean for our patients and communities,” MNA President Chris Rubesch, a registered nurse at Essentia Health, said in a statement. “Every time control over healthcare is concentrated in fewer hands, we need to understand what patients and communities stand to gain, what they could lose and who will be accountable for those outcomes.”

In a statement following Tuesday’s merger announcement, Minnesota Attorney General Keith Ellison said his office will gather public comments on the planned merger, as it reviews the proposal.

“Proposed healthcare consolidation requires close scrutiny,” Ellison said in a news release. “As we have done several times now, we will conduct a thorough review of this potential acquisition to ensure it complies with the law and is in the public interest.”

HealthPartners operates nine hospitals — including Regions Hospital in St. Paul — as well as dozens of clinics. It also offers health and dental insurance plans covering more than a 1.5 million people.

Essentia Health operates 14 hospitals and dozens of clinics in central and northern Minnesota, Wisconsin and North Dakota.

In 2025, Essentia Health was part of a proposed health system alliance involving Fairview Health Services and the University of Minnesota — but that proposal did not move forward.

In 2022, Essentia had also explored a possible merger with Wisconsin’s Marshfield Clinic Health System but later ended those discussions. Marshfield later merged with Sanford Health.

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