Health inequalities exist in varying levels among many regions and ethnic groups, but among Indigenous North American groups health inequalities are much higher and typically more severe than for almost all other groups in the United States. The Navajo Nation of the Four Corners stretches three states–Utah, Arizona, and New Mexico–with over 300,000 Navajo (Din\u00e9) people, the largest Indigenous group in the U.S. Indigenous peoples suffer many avoidable health issues, and Din\u00e9 face health inequalities such as higher than national average levels of Parkinson’s (Gordan et al.: 2013), lung and other cancers, including high rates of reproductive organ cancers in teenage girls (J.R.: 2004; \u201cDisparities:\u201d 2019; Arnold: 2014), and lower life expectancy (Smith: 2021; \u201cDisparities:\u201d 2019). Many of these issues point to environmental contamination on Navajoland due to the mishandling of over 2,000 abandoned uranium mines that were heavily active in the mid to late twentieth century, and which leak metals and nuclear waste into soil, air, and waterways (Arnold: 2014). Adding further harm is the consistently low funding by U.S. Congress of the Indian Health Services, and low numbers and accessibility of hospitals, clinics, and emergency services across Navajoland (Smith: 2021; Sugano: 2021). These inequalities reflect Turner\u2019s (1984) postulate of medicine as political in connection with necropolitics, where resources are of greater value than the \u2018disposable\u2019 people (Pele: 2020), and both medical treatment and bodily conditions are politicised within that framework. Ignorance of Indigenous health disparities and the medical-political injustice of environmental contamination of Din\u00e9 land and bodies is a form of modern colonialism that must be addressed to close health inequalities.<\/p>\n\n\n\n
There is a long history of medical injustice upon Indigenous North Americans that can be looked at as a modern extension of (post) colonialism and political injustice from the Federal<\/p>\n\n\n\n
Government. Many Federal tribal programs are consistently underfunded by the U.S. government, such as the Indian Health Service, which is within the U.S. Department of Health and Human Services. Smith (2021) points out that while the IHS is meant to provide care to over<\/p>\n\n\n\n
2.2 million Indigenous peoples, \u201cCongress has consistently underfunded the agency, forcing hospital administrators to limit the services offered\u201d and thus Indigenous communities on reservations have severely limited healthcare options and support than do other (non-Indigenous) communities. Further, Dovey (2016) points to a 2014 report showing that the IHS had been allocated $4.4 billion dollars, when the actual need was around $15 billion dollars. While the Federal government promised in 1978 to provide free healthcare to federally recognised tribal members, the historic underfunding of such programs is a clear political-medical injustice that leads to inaccessible or lacking care, staff, and facilities across reservations nationwide. This relates to the concept of necropolitics, in the sense of \u201cproducing [slow] death in a large scale\u201d where large populations may not be exploited as they were in the past, but \u201cmanaged\u2026through their exposure to deadly dangers and risks\u201d (Pele: 2020), in this case environmental contamination leading to slow death via illness. Indigenous Americans across all tribes have a life expectancy 4.4 to 5.5 times lower <\/em>than all other racial or ethnic groups in the U.S., (Smith: 2021; \u201cDisparities:\u201d 2019) and this shorter life expectancy is due to a variety of preventable illnesses, environmental contamination, and inadequate access to medical care which remain underfunded despite promises by the Federal government.<\/p>\n\n\n\n The Navajo nation has a shockingly low number of medical facilities and hospitals.<\/p>\n\n\n\n While the Navajo reservation spans over 27,000 miles, of the Indian Health Services facilities, there are only eight hospitals and thirteen health centres, with two regions having no hospital at all (Sugano: 2021). Furthermore, the distance between healthcare facilities likely increases health<\/p>\n\n\n\n inequalities, making access to healthcare treatment far less accessible. Sugano (2021) states of medical centres, \u201cEvery facility is at least 40 miles apart from the next nearest health facility\u2026Two out of the eight administrative regions do not have any hospitals [and] in these regions, the nearest hospital is nearly 100 miles away.\u201d Considering some of the major illnesses that affect the Din\u00e9, the underfunding of medical facilities, and <\/em>the distance to accessing care, these inequalities combined speak to a politicised practise of medical injustice, as the Federal government is responsible for funding and hospital planning. In citing Achille Mbembe\u2019s work on necropolitics, Pele (2020) points to how \u201csmall doses of death\u201d exist in the daily lives of those, such as Din\u00e9, whose lives are bound up by \u201csocial, economic, and symbolic violence that destroys their bodies\u201d and that these \u201csmall deaths\u201d are enacted upon by public forces through the absence of basic needs\u2013in this case, healthcare and respect for the health of their ancestral lands.<\/p>\n\n\n\n While healthcare access is insufficient, the cause <\/em>of many Din\u00e9 illnesses is a clear example of post-colonial slow death via poisoning of the land and people. The Federal government\u2019s U.S.-Navajo Treaty of 1869 promised sovereignty to the Navajo but by 1919, Indigenous lands were leased by the Interior Department for mining and resources. From the 1940s to the 1980s, in search of uranium for nuclear weapons, thousands of small and large-scale uranium mines opened across Navajoland, and many Din\u00e9 men worked in the mines\u2013though were never told of the elevated cancer risks known since at least 1879 (Arnold: 2014). The deliberate decision by mining companies and the Federal government to not acknowledge these risks, and the subsequent uranium poisoning <\/em>(Pulido: 2016) of the land and Indigenous bodies, combined with underfunded and inaccessible healthcare is an act of post-colonial medical injustice. Looking at this in terms of necropolitics as well, one can see how policies<\/p>\n\n\n\n essentialising resources over people and land, while marking the Din\u00e9 as \u201csurplus\u201d or disposable in the interests of corporate desire (Pulido: 2016), created the political-medical inequalities persisting today. This is in stark contrast to Indigenous practises of body-land interconnectivity and respect for the health of the land, which encourages healthy bodies.<\/p>\n\n\n\n Cancer among the Din\u00e9 has been connected to uranium poisoning and has a much higher incidence across Navajoland in comparison with other U.S. populations. While there are over 2,000 former uranium mine sites across the reservation, the EPA, in its slow efforts, have identified only 521 mine sites of contamination (Arnold: 2014). Many were abandoned and never cleaned up, leaving uranium dust to aerosolise, leach into soil, and mine waste has even been used in road and home construction as well as left in piles next to homes on the reservation (Arnold: 2016). When the Din\u00e9 worked in the mines they were not told that radiation was dangerous, or that they were breathing in radon gas in the mines or showering in radioactive water at home (Arnold: 2016). Children played in water from the mines that was on home property, and because the water looked and tasted clean\u2013and because they had not been told otherwise by the government or mining companies\u2013people used it for washing, cooking, and bathing, and mineworkers drank from the mine streams (Arnold: 2016), meaning that whole families were constantly exposed to radioactive toxins. In a single study from 1984, of the Din\u00e9 men in the study who had cancer, 72% had worked in the mines (Arnold: 2016), and these cancers ranged from lung to other forms of cancers, such as endocrine organ cancers. Today, cancer accounts for 7.3% of deaths among the Din\u00e9 (\u201cCancer:\u201d n.d.), and the majority of cancers are kidney, liver, and stomach\u2013all areas of the body that uranium is known to particularly affect. For teenage girls, reproductive organ cancer rates are 17 times higher than U.S. teen girls overall (J.R.: 2004) and there is strong evidence that uranium dust lingering in the air and as long term<\/p>\n\n\n\n contaminated water and soil are to blame, as uranium has been linked to acting as an estrogen in the body of developing girls (J.R.: 2004). Uranium\u2019s decay products, radium, thorium, and radon, are known to cause disruptions in DNA sequencing pre- and post-birth (Arnold: 2016) and while there have been studies done over the decades since the mines shut down, there remains a research gap in looking at the extensiveness of uranium poisoning\u2019s effects across broader age groups, to determine the extent of the effects that uranium exposure is currently having, including on new generations.<\/p>\n\n\n\n Din\u00e9 have higher rates of Parkinson\u2019s than other groups, a disease already linked to toxic metal interference. Of the many Indigenous reservations, Parkinson\u2019s is highest across Navajoland, where the highest amount of uranium mining in the U.S. was conducted (Gordan et al.: 2013). Exposure to toxic metals and radioactive materials interferes with the neural networks in the brain and damages brain tissue, causing the development of Parkinson\u2019s. Gordon et al (2013) note that Parkinson\u2019s is higher among Din\u00e9 men, though this may be due to diagnosis bias, especially considering the underfunding and inaccessibility of healthcare. Gordan et al (2013) note that Parkinson\u2019s is considered a common disease among the Din\u00e9, and Sanchez et al (2020) note that while rates of Parkinson\u2019s are highest in areas closest to abandoned mines, wind patterns may affect neuroinflammatory mine dust spreading farther as well. More research is required in this area, as is an actual consistent and determined effort to truly clean up poisoning of the land to address uranium related illness of the Din\u00e9 body across Navajoland.<\/p>\n\n\n\n In summation, the decades long medical inequalities and political injustices from the Federal government have led to decades of persisting health issues among the Din\u00e9 people. While Indigenous peoples across North America (within the United States) have lower life expectancies\u20134.4 to 5.5 times lower\u2013than all other ethnic groups and higher rates of many<\/p>\n\n\n\n diseases such as cancer, obesity, and alcohol related illnesses, the Din\u00e8 across Navajoland suffer high rates of cancers and Parkinson\u2019s related to the poisoning of their land and bodies. Uranium mining was a direct result of the Federal government shattering their U.S.-Navajo Treaty of 1869 to lease Navajo lands to private and public mining interests. This practice of post-colonial necropolitics placed land resources as indispensable over the lives of the disposable Indigenous bodies, in the name of \u2018national security\u2019 in the search for uranium for nuclear weapons. In addition to this poisoning is the large-scale medical inequality in the lack of access to medical facilities and underfunding of medicine across Navajoland. Uranium poisoning and medical inequality together lead to preventable and avoidable diseases adversely affecting Indigenous bodies. Actual significant Federal attention to these issues is critical to an honest cleanup of Navajoland, in addition to significant funding of IHS services, addressing the epidemic of unnecessary suffering of generations of Din\u00e8 people.<\/p>\n\n\n\n References<\/p>\n\n\n\n Arnold, Carrie. \u201cOnce Upon a Mine: The Legacy of Uranium on the Navajo Nation.\u201d Environmental Health Perspectives, <\/em>Vol. 122, No. 2, February 2014. https:\/\/doi.org\/10.1289\/ehp.122-A44.<\/p>\n\n\n\n \u201cCancer Among the Navajo: 2005 – 2013.\u201d Navajo Epidemiology Center, Navajo Department of Health, Navajo Nation<\/em>, n.d., https:\/\/www.nec.navajo-<\/a> nsn.gov\/Portals\/0\/Reports\/Cancer%20Among%20Navajo%202018%20Spread.pdf.<\/p>\n\n\n\n \u201cDisparities: Fact Sheet.\u201d Ihs.Gov, 2019, <\/a>www.ihs.gov\/newsroom\/factsheets\/disparities.<\/a> Dovey, Dana. \u201cHealthcare On Native American Reservations Is ‘Horrifying:’ In The US, Who<\/p>\n\n\n\n