Racism and violence, the denial and destruction of culture all seem to have had a detrimental effect on the health and wellbeing of Australia’s first peoples, resulting in high rates of health inequities. Attendees who experienced trauma may exhibit not only intragenerational reduced health status but they also pass on their competencies or perhaps, lack of competencies, to future generations. My home state of Montana includes seven reservations and multiple urban centers of American Indians, with tribal representation from many of the 657 federally recognized tribes. As a result, Indigenous Canadians face health inequities such as chronic illness, food insecurity, and mental health crises. Poor nutrition is a cumulative process because the body relies heavily on the food resources available during childhood and adolescence to determine physical abilities, cognition, and health outcomes in adulthood and beyond. The IHS has historically been inadequately funded. Thus, effective Indigenous health policies must be culturally sensitive and not impose definitions of health from ethnocentric perspectives.6 By definition, colonial policies contained culturally insensitive agendas to promote assimilation. Department of Medicine, University of Toronto, Toronto, Canada. These disparities are shaped by social inequality, historical trauma and discrimination. Indigenous populations in Canada have experienced social, economic, and political disadvantages through colonialism. The author has been privileged with life experiences from friends, family, and patients alike through his medical training to have contributed to perspectives seen in this article. Today, we know that many people on reserves suffer from impoverished living conditions and report that the lack of resources contribute to their economic insecurity.5 SES has been strongly correlated with health outcomes which is known as the socioeconomic gradient in health.4 People with lower SES tend to have reduced health status compared to their higher SES counterparts.4 This is a global phenomenon and the Indigenous population is no exception. Thank you for signing up for Indian Country News, an HCN newsletter service. However, as each year of school unfolded, I lost family members due to early causes of death, including homicide, suicide, motor vehicle accidents, cancer and pneumonia. I was an American Indian student pursuing a doctoral degree in clinical psychology in the 1990s, when I realized the stark contrast between my life experiences growing up on my home reservation and those of my non-Native peers. With the prevalence of food insecurity caused by low SES in Aboriginal families, it is possible to conclude that poor diet plays a key role in the health inequities seen on reserves. The Indian Health Service is in the position to change these trends for the better. Annie Belcourt is an Associate Professor of Health Professions and Biomedical Sciences at The University of Montana. A significant number of Aboriginals cannot afford medical treatment or transportation to hospitals, illustrating the severity of relative poverty being experienced on reserves.22 Their ability to access appropriate medical attention is limited by their low SES, which is a direct causative relationship to the poor health seen in Aboriginal communities across the nation. However, it is the interrelatedness of these dimensions that … American Indians live on average 20 years less than whites in the state. Globally such health inequities are similar and require interventions supported by governments in conjunction with health and education systems to affect desired change. This includes racism, aggression and disrespect, among many other systemic barriers and inequities. The effects of colonialism on the Canadian Aboriginal population are far-reaching and evident in the health inequities seen today. I sit in my office today, looking upon the photos of family members lost too soon, and reflect upon the hope of healthier futures for my daughters, my niece and all Native youth. The Keystone XL Pipeline threatens to spread more than just oil through Indigenous communities. In childhood, access to quality education is a protective factor for future health status because it promotes academic and social skills development, increases health literacy, and enables positive interpersonal development.11 However, this is only possible if the educational setting is provisioned with caring instructors, support networks, and ample resources to maintain a rich learning environment. Indigenous Peoples face alarming health inequities Indigenous Peoples across Canada face numerous barriers when it comes to accessing healthcare. Health inequality The IHS is the primary health care provider for most American Indians. To provide culturally sensitive care for those who have experienced intergenerational trauma, health care providers should be aware of and understand two key SDOH inequity influencing the Indigenous life course, including the residential school system and loss of socioeconomic status, over time due to colonialism. Australia’s Health 2014 report states: “Many factors contribute to the gap between Indigenous and non-Indigenous health. Instructors enforcing these policies further contributed to the problem by verbally, emotionally, and even physically abusing students.5 As a child, negative relationships with caregivers and teachers can have serious implications on behavior, adjustment, and attitudes in adolescence and early adulthood.14 Childhood abuse has also been linked to poor health status, leading to increased hospitalizations for physical and psychological illnesses in adulthood.15 In a 2012 study by Elias et al.,16 48.1% of residential school attendees reported an abuse history, and those who were abused experienced increased rates of suicidal thoughts and suicide attempts. 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