The health and wellbeing of Indigenous adolescents: a global collective for an equitable and sustainable future

Abstract

Indigenous peoples, comprising almost 500 million individuals from across 90 countries, hold the longest continuous cultures on this planet. 1 UN Department of Economic and Social AffairsState of the world's Indigenous peoples: rights to lands, territories and resources. UN Department of Economic and Social Affairs, New York2021https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2021/03/State-of-Worlds-Indigenous-Peoples-Vol-V-Final.pdfDate accessed: December 16, 2021 Crossref Google Scholar Despite the negative impacts of colonisation, Indigenous peoples have survived and continue to nurture and live their Indigenous knowledges, languages, and cultural practices. Indigenous peoples have made substantial contributions to global health. For example, the parts of the health sector controlled by the Indigenous community in Australia helped shape the principles of primary health care in the pivotal Alma-Ata Declaration in 1978, 2 WHOPrimary Health Care: Report of the International Conference on Primary Health Care Alma-Ata, USSR, 6–12 September 1978. World Health Organization, Geneva1978 Google Scholar which is a foundation of universal health coverage. The Southcentral Foundation's Nuka System of Care, based in Alaska, USA, is an example of Indigenous community-driven overhaul of the health system to enable care that is holistic, sustainable, and aligned with community needs. 3 Gottlieb K The Nuka System of Care: improving health through ownership and relationships. Int J Circumpolar Health. 2013; 7221118 Crossref Scopus (91) Google Scholar More recently, Indigenous communities have exemplified effective, evidence-based strategies to respond to COVID-19. 4 Finlay S Wenitong M Aboriginal community controlled health organisations are taking a leading role in COVID-19 health communication. Aust N Z J Public Health. 2020; (published online June 24.)https://doi.org/10.1111/1753-6405.13010 Crossref Scopus (20) Google Scholar , 5 Eades S Eades F McCaullay D Nelson L Phelan P Stanley F Australia's First Nations' response to the COVID-19 pandemic. Lancet. 2020; 396: 237-238 Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar , 6 Petrov AN Welford M Golosov N et al. Lessons on COVID-19 from Indigenous and remote communities of the Arctic. Nat Med. 2021; 27: 1491-1492 Crossref PubMed Scopus (5) Google Scholar , 7 Kaplan HS Trumble BC Stieglitz J et al. Voluntary collective isolation as a best response to COVID-19 for Indigenous populations? A case study and protocol from the Bolivian Amazon. Lancet. 2020; 395: 1727-1734 Summary Full Text Full Text PDF PubMed Scopus (26) Google Scholar , 8 Silberner J Covid-19: how Native Americans led the way in the US vaccination effort. BMJ. 2021; 374n2168 Crossref PubMed Scopus (1) Google Scholar The potential for Indigenous knowledge and wisdom to manage complex ecosystems, amassed through stewardship of biologically diverse lands over thousands of years, can also help address the global climate crisis. 1 UN Department of Economic and Social AffairsState of the world's Indigenous peoples: rights to lands, territories and resources. UN Department of Economic and Social Affairs, New York2021https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2021/03/State-of-Worlds-Indigenous-Peoples-Vol-V-Final.pdfDate accessed: December 16, 2021 Crossref Google Scholar , 9 Swinburn BA Kraak VI Allender S et al. The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. Lancet. 2019; 393: 791-846 Summary Full Text Full Text PDF PubMed Scopus (772) Google Scholar Yet, Indigenous peoples have been largely excluded from health policy and action, both globally and locally. Where Indigenous peoples are included, it has mostly been to address health inequities that stem from colonisation and associated genocide and subjugation, systemic racism, and forced displacement from family, community, land, and culture—determinants largely not controlled by Indigenous people. 10 Anderson I Robson B Connolly M et al. Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study. Lancet. 2016; 388: 131-157 Summary Full Text Full Text PDF PubMed Scopus (454) Google Scholar , 11 King M Smith A Gracey M Indigenous health part 2: the underlying causes of the health gap. Lancet. 2009; 374: 76-85 Summary Full Text Full Text PDF PubMed Scopus (724) Google Scholar