Decolonization is the process of achieving health equity by addressing and reversing the negative, ongoing impacts of colonization. For many countries, this process begins with becoming independent of the colonizing country through achieving statehood, and continues through uprooting social, psychological, economic, environmental, and other impacts of colonization. However, in the United States and similar places that experienced settler colonialism (a form of colonialism where Indigenous peoples were systematically replaced by settlers forming permanent societies), independent statehood was achieved by white settlers, which deepened colonialism, rather than the beginning of independence and autonomy. For these countries, decolonization involves a deeper, more complex dismantling of structural power and privilege.
All peoples and cultures have the right to existence, autonomy, and self-determination. The process of colonization in the Americas resulted in the deaths of 56 million Indigenous peoples (90% of the Indigenous population and 10% of the global population at the time), the largest event of mass death—by global population percentage—in human history. In the United States, settler colonialism continues to perpetuate the impacts of Indigenous genocide through ongoing power systems that repress and deny the inherent rights and value of Indigenous communities. The same colonial practices and systems designed to erase and repress Indigenous peoples also create and reinforce hierarchies of race, gender, orientation, ability, age, religion, language, socioeconomic status, and legal status that negatively impact all marginalized people and our entire society as a whole.
Today, decolonization efforts by Indigenous activists, scholars, and community leaders are restoring power, health, and well-being to Indigenous communities. Indigenous people and allies with intersectional identities (such as Two Spirit people, queer Indigenous people, and disabled Indigenous people) are also leveraging decolonization theory and practice to advance health equity for all Americans by uprooting oppressive power structures and building new, equitable, just systems.
Despite significant grassroots and community-based efforts to reverse the ongoing effects of colonization, more is needed to address the United States’ legacies of inequity at the institutional, systemic, and cultural levels. Native Americans, Native Hawaiians, and Alaska Natives often struggle with missing, low-quality, and inaccurate data regarding their communities, as well as chronically low governmental and philanthropic investments. U.S. foundations give an average of 0.4% of total funding to Native American communities and causes, and billions of federal dollars are inaccessible to Native American communities because many culturally-appropriate interventions are not considered evidence-based.
At scale, advancing health equity through decolonization requires deeply uprooting colonial power structures, ideologies, and practices that perpetuate harm for Indigenous and other marginalized communities. Improving community-owned data and increasing funding streams for Indigenous communities are two critical foundational pieces of this work. Changemakers can also support justice and well-being by centering Indigenous issues and perspectives, genuinely valuing Indigenous ways of being and knowing, advocating for the return of Indigenous land, paying reparations to Indigenous peoples, and supporting Indigenous communities’ decolonization practices—such as revitalizing Indigenous languages and spiritual practices.