White text on red background reading "Wëlamàlsëwakàn (Good Health)"

What Can Public Health Learn from Indigenous Knowledge Systems?

October 16, 2023

Indigenous People’s Day is observed on the second Monday of October and honors indigenous communities around the world while recognizing a fraught history of colonialism and forced migration. A recent Grand Rounds discussion continued these conversations by posing a critical question: What would it take to increase public health in indigenous communities? (Watch a video of the event below.)

A man in a grey sweater at a podium smiles

Kevin Patterson

Yoshira “Yoshi” Ornelas Van Horne, assistant professor of environmental health sciences, moderated the event, which included perspectives from Hadrien Coumans, co-director of the Lenape Center, Rae O’Leary, a public health analyst and member of Columbia University Northern Plains Superfund Research Program, and Population and Family Health Professor Kayum Ahmed, PhD ‘19. Dean Linda P. Fried opened the event, and Diné PhD student Kevin Patterson led the group in a land acknowledgment.

Health disparities between indigenous Americans and the broader population can be directly traced to violence against indigenous populations. O’Leary pointed to colonization as the root cause of poor health. A member of the Turtle Mountain Band of Chippewa, O’Leary explained, “Pre-contact, my ancestors’ primary health threats were malnutrition and infectious disease, but following colonization rates of death and disease became catastrophic.”

The land Columbia stands on once belonged to the Lenape tribe, who governed land spanning parts of New York, Pennsylvania, Connecticut, Delaware, and New Jersey, according to Coumans. By 1853, however, the largest group of Lenape people, who were referred to as the Delaware, numbered fewer than 900 individuals, or 25 families. “There’s no other word besides genocide to describe what happened here,” Coumans said. Meanwhile, colonist actions like the clearcutting of forests were “ecocide” driven by an extractivist system that continues today.

In recent years, public health researchers have forged partnerships with indigenous researchers and community leaders to identify and address health risks. The Columbia University Northern Plains Partnership for the Superfund Research Program (CUNP-SRP) is investigating the health effects, geochemistry, and remediation of arsenic and uranium. Hazardous metals in drinking water, common near Superfund sites and abandoned uranium mines, play a role in the high burden of heart disease and diabetes affecting rural communities in the U.S. Northern Plains, including tribal communities.

According to O’Leary, efforts like CUNP-SRP, in which she is a member, must strive for research design that recognizes the diversity within the indigenous community, tribes’ ownership of data, acknowledgment of history in the research process, and clear, consistent implementation efforts. In doing this, she said research can align with the Seven Generations mindset or belief that it is “our responsibility living in today's generation to learn from ancestors seven generations behind us.” Simultaneously, individuals must “look ahead seven generations to make sure that we are laying a good foundation…for all of the generations to come beyond us.”

A seated women wearing a blazer speaks into a microphone

Professor Yoshira Ornelas Van Horne

Despite projects like these and public health’s inclination towards justice and equity, academic institutions can and should do more to elevate indigenous groups, the speakers said, including by recruiting greater numbers of indigenous students and faculty. On a more fundamental level, schools of public health should also work to incorporate indigenous knowledge systems, said Ahmed. At the same time, care must be taken when incorporating indigenous concepts “into existing systems that are foundationally not aligned,” according to Coumans. To this end, he and Ahmed recently published a paper titled “Wëlamàlsëwakàn (Good Health): Reimagining the Right to Health through Lenape Epistemologies.” This coming spring, for the first time, the Lenape Center will teach a course at Columbia Mailman on indigenous knowledge systems. Coumans expressed hopes it will lead to more robust partnerships, saying, “it is really a seed.”

Indigenous concepts that question fundamental beliefs around personhood and that strive for harmony between humanity and nature are now being rediscovered because of the climate crisis, and according to Coumans, offer an opportunity to address this crisis. One example is replanting certain corn varieties cultivated by many generations of indigenous people instead of relying on monoculture crops of the kind propagated by factory farming. “We cannot talk about human health without talking about the health of the planet,” Ahmed added. Van Horne agreed, saying, according to indigenous knowledge systems, “to be of the Earth means acknowledging that our health and the health of our non-human relatives are interconnected.”

A Healthy and Just World: What would it take to increase public health in Indigenous communities?