Reparations for Indigenous Peoples in the USA and Canada

Indigenous populations comprise some 400 million people worldwide, hailing from 5,000 descent communities. Although contemporary Indigenous Peoples are exceedingly diverse, they frequently share brutal histories of colonization. These histories of subjugation by outsiders have yielded catastrophic impacts on Indigenous health and well-being, including marked inequities in health status. Specifically, Indigenous communities often suffer from disproportionately high rates of infant and maternal mortality, infectious diseases, parasite loads, diseases of forced acculturation (such as diabetes and hypertension), exposure to environmental contaminants, and stark anomic health conditions (such as addiction, violence, suicide). Even in the comparably wealthy nations of the USA and Canada, Indigenous health inequities persist. It is common to attribute Indigenous health inequities to poverty and despair; and yet, for most Indigenous Peoples, these disparities result from harms that were deliberately engineered by others. Repair for colonial legacies of poor health within Indigenous communities will require adequately funded healthcare, robust social services, and the eradication of poverty. Beyond this, reparations for Indigenous Peoples should include recognition of Indigenous sovereignty, honoring of historical treaties, and return of Indigenous lands.Author summary: Contemporary Indigenous populations number around 400 million people worldwide. Although Indigenous Peoples are exceedingly diverse, they frequently share histories of colonial subjugation by outsiders. Histories of colonial subjugation have yielded catastrophic impacts on Indigenous health and well-being. Although commonly attributed to poverty and despair, health inequities for most Indigenous communities typically resulted from harms engineered by others. Repair for colonial legacies of poor Indigenous health will require adequately funded healthcare, robust social services, eradication of poverty, recognition of Indigenous sovereignty, and return of Indigenous lands.