The Colonial Medicine of Settler States: Comparing Histories of Indigenous Health

The history of Indigenous health connects inextricably with matters of geography and colonisation. 'Indigenous' usually connotes a place, often figured as marginal or isolated or developmental - as somewhere else.1 More pertinently, Indigenous status implies - or rather, is predicated upon - a history of colonisation and dispossession, with consequent resistance and adaptation to invaders and settlers. The term marks the contrast between original inhabitants and colonisers. The effort to identify some special Indigenous essence or type ultimately is futile since the status emerges out of political subordination under settler colonialism.2 The history of Indigenous health thus demands sensitivity to the impact of both colonialism and the incipient white nation-state. Moreover, it requires a critical awareness of the dark sides of contact, 'civilisation,' and 'development,' as well as an appreciation of the multiple implications of the related processes of assimilation, integration, and self-determination.3 Since first contact with European invaders, Indigenous people on the whole have been sicker and died younger than non-Indigenous inhabitants of the same colony or state.4 These health disparities have lessened significantly in North America and New Zealand, but remain severe across Australia.5 During the late-twentieth century, some historians attempted to explain the initial colonial impact on Indigenous societies in biological terms. Thus infectious diseases swelled the 'ranks of death,' as Indigenous people suffered 'virgin-soil' epidemics, the natural result of 'ecological imperialism.'6 As most of these historians later conceded, such biological analysis tended to discount the unnatural effects of warfare, dispossession, and demoralisation on health and social organisation.7 Biological explanations of contemporary health disparities are largely out of fashion - the