American Indian and Alaska Native (AI/AN) land rights, sovereignty conflicts, and health outcomes have been significantly influenced by settler colonialism. This principle has driven the numerous relocations and forced assimilation of AI/AN children as well as the claiming of AI/AN lands across the United States. As tribes across the country begin to reclaim these lands and others continue to struggle for sovereignty, it is imperative to recognize that land rights are a determinant of health in AI/AN children. Aside from the demonstrated biological risks of environmental health injustices including exposure to air pollution, heavy metals, and lack of running water, AI/AN children must also face the challenges of historical trauma, the Missing and Murdered Indigenous Peoples crisis, and health care inequity based on land allocation. Although there is an undeniable relationship between land rights and the health of AI/AN children, there is a need for extensive research into the impacts of land rights and recognition of sovereignty on the health of AI/AN children. In this article we aim to summarize existing evidence describing the impact of these factors on the health of AI/AN children and provide strateg ies that can help pediatricians care and advocate for this population.

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