Extensive mercury contamination and angler selection of the most contaminated fish species coincide in California's Central Valley. This has led to a policy conundrum: how to balance the economic and cultural impact of advising subsistence anglers to eat less fish with the economic cost of reducing the mercury concentrations in fish? State agencies with regulatory and other jurisdictional authority lack sufficient data and have no consistent approach to this problem. The present study focused on a critical and contentious region in California's Central Valley (the Sacramento-San Joaquin Rivers Delta) where mercury concentrations in fish and subsistence fishing rates are both high. Anglers and community members were surveyed for their fish preferences, rates of consumption, the ways that they receive health information, and basic demographic information. The rates of fish consumption for certain ethnicities were higher than the rates used by state agencies for planning pollution remediation. A broad range of ethnic groups were involved in catching and eating fish. The majority of anglers reported catching fish in order to feed to their families, including children and women of child-bearing age. There were varied preferences for receiving health information and no correlation between knowledge of fish contamination and rates of consumption. Calculated rates of mercury intake by subsistence anglers were well above the EPA reference dose. The findings here support a comprehensive policy strategy of involvement of the diverse communities in decision-making about education and clean-up and an official recognition of subsistence fishers in the region.