The document highlights the systemic and historical factors driving health inequities among American Indians and Alaska Natives (AI/AN). It outlines how colonization introduced structures like federalism, capitalism, and forced assimilation policies, leading to generational poverty, historical trauma, diminished resources, and exclusion from decision-making. These systemic injustices have resulted in severe health disparities, including lower life expectancy and higher rates of preventable diseases, perpetuating challenges for AI/AN communities.