Reconciliation and Indigenous self-determination in health research: A call to action

As Section Editors of the Indigenous Health section of PLOS Global Public Health, we were asked to think about the urgent health priorities facing Indigenous people around the world.A challenging task as the diversity amongst Indigenous people is great; and local relationships with structures, policy, our relatives, and the land will create greater diversity in the health challenges we face.A common challenge for most, if not all, Indigenous people globally is the ongoing impact of colonialism and systemic racism encountered within our health care systems.There is irrefutable evidence that Indigenous people living in Canada and Australia experience racism in the healthcare system [1][2][3][4].In 2015, the Truth and Reconciliation Commission of Canada (TRC) released 94 Calls to Action compelling Canadian institutions across service sectors (i.e., education, child welfare, criminal, justice, healthcare) to acknowledge that colonization is the principal driver of population-level health disparities experienced by Indigenous people [5].Within Australia, the Mayi Kuwayu Longitudinal Study is a ground-breaking study that is examining the centrality of culture and is asking what culture means for Aboriginal and Torres Strait Islander Peoples.Data collected by the Mayi Kuwayu study between 2018-2020 highlighted the breadth and the extent of racism on the health and wellbeing of Aboriginal and Torres Strait Islander people, and that across the board links with racism were identified within mental health, physical health and cultural wellbeing [6].Additionally, evidence shows that Indigenous self-determination is an important factor in maintaining well-being and contributes to positive health outcomes [7].These rights to self-determination and sovereignty are further entrenched to the UN Declaration of Rights for Indigenous People [8] and defined there as:Article 3 Indigenous peoples have the right to self-determination.By virtue of that right they freely determine their political status and freely pursue their economic, social and cultural development.Article 4 Indigenous peoples, in exercising their right to self-determination, have the right to autonomy or self-government in matters relating to 4.Resolution 217 A (III). 5 their internal and local affairs, as well as ways and means for financing their autonomous functions.