On August 5th, 2015, 3 million gallons of acid mine drainage was accidentally discharged from the Gold King Mine near Silverton, Colorado into Cement Creek, which is a tributary of the Animas and San Juan Rivers. The government-initiated risk assessment only assessed a recreational scenario (i.e. hiker drinking from the river), failing to recognize the deep connection of the Diné (Navajo) with the San Juan River for spiritual, cultural, and agricultural practices. The aims were to quantify impacts of the 2015 Gold King Mine Spill (GKMS or Spill) on Diné activities and to determine differences in activity patterns by demographics. Dr. Chief conducted twelve focus groups in three Navajo communities to identify interactions between the Diné and San Juan River. An analysis of focus group transcripts revealed 43 unique activities with five distinct categories: livelihood, recreational, cultural and spiritual, dietary, and arts and crafts. Based on these five categories, the presenter developed a questionnaire to collect pre- and post- GKMS Diné activity frequency and duration. Navajo Community Health Representatives administered the questionnaire to 63 Diné adults and 27 children living in three Navajo communities along the River. On average, Diné activities with the San Juan River following the GKMS decreased by 56.2%. The decrease in activity number (overall and cultural) and frequency (overall, cultural, and dietary) was significantly different by age, with adults having a greater reduction compared to children. The significant reduction in activities following the GKMS may lead to long-term trauma, affecting the ability of the Diné to pass down teachings to their children affecting future generations to come. The 43 distinct activities between the Diné and the San Juan River highlight the importance for scientists and disaster responders to include cultural and spiritual factors when responding to environmental disasters and conducting a risk assessment in an Indigenous community.