This story is published as part of the Global Indigenous Affairs Desk, an Indigenous-led collaboration between Grist, High Country News, ICT, Mongabay, and Native News Online.

This year’s United Nations Permanent Forum on Indigenous Issues is focusing on human, territorial, and planetary health. The Permanent Forum is in its 22nd session. 

A recent report, “Indigenous Determinants of Health,” is a culmination of 20 years of work that the Permanent Forum has been doing. It was released this session. The Permanent Forum lasts two weeks and consists of interventions, which are essentially calls to action, and side events on various issues.  

Many Indigenous leaders have spoken about how planetary health and the health of Indigenous people and communities are intertwined, becoming ever more important as the world experiences irreversible damage caused by climate change. 

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A report like this by the U.N. is the first of its kind. 

The study was meant to inform non-Indigenous policymakers about how to approach health and wellness for Indigenous communities and to fill the gap in U.N. literature that previously did not address the holistic, historical, and political aspects that encompass Indigenous health, in comparison to other minority groups.  

This report was in some sense a response to the 2030 Agenda for Sustainable Development, a U.N. agenda that seeks to “end poverty and hunger, realize the human rights of all, achieve gender equality and the empowerment of all women and girls, and ensure the lasting protection of the planet and its natural resources,” according to its website. The agenda has 17 concrete goals to achieve by 2030. 

“The past seven years, however, have shown the urgent need for guidance on — and a proper understanding of — Indigenous Peoples’ needs, separate from the general minority and diverse population approaches,” the report states. “The coronavirus disease (COVID-19) pandemic highlighted the entrenched inequities faced by Indigenous Peoples in all 17 Goal areas and how the severe lack of cultural competence within the 17 Goals negatively impacts Indigenous Peoples’ health.”

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The report uses the framework of the World Health Organization’s definition of social determinants of health, meaning the social, political, economical, and cultural factors that affect a person’s health. One specific example would be the lack of access to grocery stores on the Navajo Nation and how not having access to fresh foods impacts a person’s health.  

“We tend to look at measures like poverty or poor educational attainment or inadequate housing as determinants of bad health outcomes,” Dr. Donald Warne, one of the authors of the report and co-director of the Johns Hopkins Center for Indigenous Health, told ICT. “But we also know that there are strengths as well, particularly with Indigenous cultures. We know that language preservation, cultural connectedness, participation in ceremony, are actually protective of health. We want to think of Indigenous determinants of health as not just the causes of health disparities, but the sources of strength to overcome some of those challenges.” 

The Indigenous determinants of health runs parallel to this definition by acknowledging the unique challenges, worldviews, and political status of Indigenous nations. More importantly this report is a call to action.       

“This study is intended to create tangible outcomes for Indigenous peoples at the local level. Everything we do here should be focused on improving the health and wellness of our local Indigenous peoples through these interlinked determinants of health, whether it be climate change, planetary and territorial health, mental health, maternal and child health, primary care, and more,” Geoff Roth, Standing Rock Sioux descendant and elected member of the Permanent Forum, said in his speech at the U.N. headquarters.

There are 37 other recommendations that could be immediately implemented on the collaboration between Indigenous nations and local health agencies. It ranges from reinforcing Indigenous identities to supporting and protecting the use of medicinal plants. 

“My role was mainly on the intergenerational holistic healing component and there’s 15 recommendations just within that one component,” Warne, who is Oglala Lakota, said. “A couple of things that I think are very important is to recognize that as a medical educators, we are not doing a good job in medical education and public health education, or really any health science, in understanding the impact of historical trauma, the impact of colonization, and the need for more trauma-informed care.”

Next month at the World Health Assembly in Geneva, Brazil will present a resolution that acknowledges Indigenous peoples’ right to health care and to govern their own health care facilities. The World Health Assembly is composed of 194 member states that address global health emergencies. Brazil’s resolution will also call for the World Health Organization to create a plan that addresses Indigenous peoples’ health by next year. 

“We ask you to encourage your member states to support this resolution that will be offered by Brazil at the upcoming World Health Assembly in Geneva,” Roth said. 

Member states, meaning countries like the United States and Canada, are represented by an appointed delegate to the U.N. For example, Ambassador Linda Thomas-Greenfield represents the United States in the U.N. General Assembly, the policy making arm of the organization.   

Ultimately this report seeks to explain that Indigenous health encompasses more than just access to care. 

“Member states must recognize that there are unique determinants of health specific to Indigenous peoples, our cultures, histories, political status, spirituality, and our current experience,” Stacy Bohlen, executive director of the National Indian Health Board, said. “All Indigenous peoples’ interactions and connections to spirituality, social life, and environmental elements are substantively distinct from those of all other populations around the globe. Indigeneity as an overarching determiner of health is the foundation of our work.”

“One of the strongest suggestions that we make is that the [World Health Organization] and [Pan American Health Organization] incorporate the concept of Indigeneity as an overarching determinant of health in all of their work, policies, body of knowledge, and initiatives,” Roth said. “As such, Indigeneity would encompass all of the specific circumstances included in the Indigenous determinants of health study that we are presenting today.”

The Global Indigenous Youth Caucus, which represents youth from all seven regions of the U.N., has called on the Permanent Forum and General Assembly to create permanent intergenerational, Indigenous advisory groups for all bodies of the U.N., including the World Health Organization, make violence against Indigenous women a thematic mandate, meaning a specific issue of human rights, and encourage member states to support traditional health practices in accordance with the United Nations Declaration of Indigenous Rights.

“Create binding resolutions in regards to climate actions,” Lahela Mattos, a member of the youth caucus, said. “Climate change is indeed one of the largest threats to the peace and security of all nations and peoples.”

Mattos, 23, was flanked by a handful of her peers from the Global Indigenous Youth Caucus, one hand on her shoulder, as she addressed hundreds of people from around the world on Tuesday. 

“For Indigenous peoples, wellness is defined through the interconnectedness and balance of physical, mental, cultural, and spiritual health,” Mattos, a Native Hawaiian, said in her speech. “We urge the General Assembly to include the rights of Indigenous people as a social determinant of health as Indigeneity is a determinant of health. Returning lands and waters, lands and waters stewardship, and honoring the rights of Indigenous peoples improves human and planetary health and is a solution to the climate crisis.”