Water (in)security and American Indian health: social and environmental justice implications for policy, practice, and research

Objectives: The objectives of this research were to examine the relationship between water insecurity and Indigenous health and highlight the social and environmental justice implications water insecurity has for practice, policy, and research with Indigenous communities. Study design: A literature search design was used. Methods: A review of the concepts of water insecurity within an Indigenous context is described through three illustrative case studies. Results: For Indigenous people, water takes on a much greater significance as it is connected to the culture, identity, and livelihoods of Indigenous communities. Although a vast range of determinants influence Indigenous health, water continues to be an integral component of Indigenous health globally. Conclusions: Water is a finite resource, and it is anticipated that water insecurity will grow as water resources are stressed and become scarcer globally. Having safe sustainable water resources by itself will not necessarily result in significant health improvements as there are many other factors involved. However, safe, sustainable water resources are a necessity for health, and health equity is a prerequisite for social and environmental justice for Indigenous people.