Health Outcomes for American Indian and Alaska Native Children Relates to Land Rights: Pediatrics Special Article

A special article, “Land Rights and Health Outcomes in American Indian/Alaska Native Children,” published in the November 2021 Pediatrics details the origins of longstanding inequities that impact Indigenous children and urges for pediatricians to advocate for systemic change. The commentary, published online Oct. 27, provides background and context concerning the relationships that Indigenous peoples have with their land that are tied to culture, health, and wellbeing. The authors describe how settler colonialism ultimately eliminated self-determination and access to resources and predisposed American Indian and Alaska Natives (AI/AN) to experience traumas and health disparities. The authors state that it is imperative to recognize that land rights are a determinant of health in Indigenous children, from the biological risks of environmental health impacts to challenges based on historical trauma; the Missing and Murdered Indigenous Peoples (MMIP) crisis; and healthcare inequity based on land allocation. American Indian and Alaska Native children also experience violence and physical, sexual, and emotional abuse at rates higher than any other ethnicity in the U.S., with the Indian Health Service (IHS) estimating 20% of children experience physical or sexual abuse by age 18. The authors suggest that pediatricians, through heightened awareness, can offer culturally grounded interventions, screen for exposures to abuse and violence, partner with tribal organizations in advocating for AI/AN youth and promoting inclusive medical education.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.