Settler colonialism makes Indigenous peoples sick: Bram Wispelwey, Lana Ray, Dina Hamideh, Steven De La Torre, Nadine Bahour, Artair Rogers, David Mills, Eric Hekler, ‘Constructing the Settler Colonial Determination of Health: Causality by Other Means’, Social Science & Medicine, 2026 | settler colonial studies blog

Settler colonialism makes Indigenous peoples sick: Bram Wispelwey, Lana Ray, Dina Hamideh, Steven De La Torre, Nadine Bahour, Artair Rogers, David Mills, Eric Hekler, ‘Constructing the Settler Colonial Determination of Health: Causality by Other Means’, Social Science & Medicine, 2026

04Aug26

Abstract: Indigenous communities have long identified settler colonialism as foundational in conditioning health and wellbeing, and its role as a structuring force is increasingly recognized within population health. Yet analytic frameworks in the health sciences have limitations in representing its causal dynamics, with dominant epidemiologic approaches relying on causal assumptions—linearity, discrete exposures, and stable pathways—that are misaligned with its theorized properties as a dynamic, transtemporal, and adaptive social process. To investigate settler colonialism, we argue for epistemic fit across three interdependent layers: teleological clarity regarding the purposes orienting inquiry and the competing social visions at stake, including commitments to relationality rather than domination; ontological precision in mapping settler colonialism’s functions to their context-specific manifestations; and methodological approaches capable of representing feedback, emergence, conditioning, and historical dependence. Drawing on theory construction methodology, we develop a provisional framework for the settler colonial determination of health. Within this framework, settler colonialism is conceptualized not as a discrete determinant among others, but as a conditioning and transtemporal social formation that shapes institutions, processes of racialization and gendered power, and ultimately health outcomes. We outline implications for empirical research, highlighting configurational, dynamic, and systems-oriented approaches as strategies for representing settler colonialism’s multi-causal and adaptive impacts on health. By extending existing population health frameworks, this approach provides a foundation for developing empirically tractable models that more adequately represent settler colonialism’s relational, historical, and adaptive dynamics. Advancing such approaches is essential for generating explanations—and ultimately interventions—commensurate with health inequities in settler colonial contexts.

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