Impact of Settlement on Indigenous Health

By the 16th century, Indigenous peoples on North America’s Atlantic coast had regular contact with European fisherman and explorers. Around this time the Indigenous population in North America was estimated to be at least 200,000 people, with some scholars arguing it could have been as high as 90 million people (Daschuk, 2014, p. 1). As colonization unfolded the Indigenous population would drop significantly as the result of disease, war, famine, and other disruptions to Indigenous life. By the 17th century trade relationships had developed between Indigenous people and Europeans. As these relationships developed and Europeans pushed inland, diseases like tuberculosis, smallpox, and measles spread across the continent, and new viruses and bacteria were introduced to both populations (FHNA, n.d.). Though Tuberculosis and other diseases had been present in North America before colonization, poor conditions in early settlements promoted their spread (Daschuk, 2014, p. 2). Additionally, some of the diseases spread through settlement like measles and smallpox were previously unknown to Indigenous people, and so without developed immunity, or medical knowledge for treatment many communities were devastated (Burnett, 2023).

During early trade and settlement, mission schools were set up to assimilate Indigenous children into Christianity. These schools were the precursor to the residential school system set up by the Canadian government which existed from 1883 to 1997 (Miller, 2024). This system is widely acknowledged as having extensive negative impacts on Indigenous health. Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada states:

Contemporarily, much health research considers the legacy of residential schools a core consideration for Indigenous health. It is recommended that clinicians familiarize themselves with this history as it is essential to providing culturally safe care for Indigenous patients.

In addition to direct threats to health such as war, disease, poverty etc. colonial law also impacted Indigenous health. The Indian Act outlawed many cultural practices which contributed to Indigenous well-being, confined Indigenous peoples to narrow tracts of land (thereby cutting them off from traditional sources for food and medicine) and imposed patriarchal rules which disenfranchised Indigenous women to speed up assimilation and disrupt Indigenous family systems (Johnson, 2017). All these factors in settlement suppressed Indigenous well-being, contributed to the discriminatory attitudes towards Indigenous people and traditions, and eventually forced Indigenous peoples to rely on the government for access to resources, including healthcare (FNHA, n.d.)

The Royal College of Physicians and Surgeons’ Indigenous Health Primer identifies that paternalistic attitudes in colonial research and care have contributed to the severe harm experienced by Indigenous peoples (2019).  Examples of this mistreatment are coercive sterilization and abortion; compulsory and segregated hospitalization; experimentation without consent; biological warfare; forced starvation and destruction of Indigenous food security (The Royal College of Physicians and Surgeons, 2019). In addition to medical harm, the result of these colonial practices has been a profound loss and suppression of Indigenous health knowledge, discrimination against traditional healing within both settler and Indigenous communities, and the disempowerment and loss of autonomy of Indigenous people with regard to their health.