Disruption Then Disease: Contextualizing Colonization and Disease in Indigenous North America

Tai S. Edwards

Simplicity is often appealing, especially when examining Indigenous peoples’ histories in North America. Most people in the U.S. think they understand the impact of European diseases (sometimes called “virgin soil” epidemics) on Indigenous communities. My students can easily recount tales of epidemics—usually smallpox—supposedly spreading like “wildfire” and the accidental, though “tragic,” death of most Indigenous North Americans rapidly thereafter. Even the blockbuster “Barbie” movie incorporated this narrative. One of the film’s major storylines centered around the sudden demise of the Barbies’ supremacy in Barbie Land as the Kens instituted their brand of patriarchy in the rechristened “Ken Land.”  When asked how they took control so thoroughly, Ken replied, “We just explained to them the immaculate, impeccable, seamless garment of logic that is patriarchy, and they crumbled.” Reflecting on this swift conquest, Gloria—a human character from the “real world”—exclaimed, “Oh my God! This is like in the 1500s with the Indigenous people and smallpox. They had no defenses against it.”

But this story is not true. For decades, meticulous research by many scholars has either complicated or refuted it. So, what have we learned about the connections between colonization and disease?

Epidemics did not strike immediately, nor did they spread quickly or uniformly as Europeans colonized the Americas. In other words, diseases did not spread like “wildfire.” Smallpox was a childhood disease in Europe. However, early colonizers were adults who spent weeks at sea, making them unlikely transmitters. It took twenty-five years before smallpox emerged in the Caribbean colonies; nearly a century before epidemics developed among the Pueblos whose homelands the Spanish called New Mexico; and archaeologists cannot find evidence that Hernando de Soto and his crew ignited any on his east-to-west trip inland from the Gulf coast. Even in Spain’s brutal California missions, measles and smallpox did not strike until 1806 and 1833, decades after they were established. And the Comanche, empowered by their acquisition of Spanish horses, did not experience devastating epidemics until the 1840s.[1]

To understand disease, we must evaluate the colonial context for each Indigenous community. “Warfare, enslavement, land expropriation, removals, erasure of identity, and other non-disease factors…worked in deadly cabal with germs to cause epidemics, exacerbate mortality, and curtail population recovery.”[2] European colonization disrupted many aspects of Indigenous life, compromising mental and physical health that then made Native people vulnerable to epidemics.[3] I tell my students to write in their notes: “it was disruption then disease.”

For example, it took more than two decades after Columbus commenced Western Hemisphere colonization for large Spanish settlements to emerge in the Caribbean colonies. Growing populations of children and enslaved Africans dramatically expanded the populations vulnerable to smallpox, and epidemics spread along shipping routes beginning in 1518. One such outbreak in Cuba in 1519 coincided with the conquest of Mesoamerica, led by Cortés, where hundreds of men invaded—and thus, disrupted—densely populated mainland Indigenous communities, enabling local spread of the disease over the next several years.[4]

Nonetheless, there is no evidence that smallpox spread north of Mexico, where Indigenous communities were far less densely settled. In northeast North America, evidence suggests Mohawk population growth during the sixteenth century, even as they interacted periodically with Europeans on nearby trading and fishing ships. By the 1630s, though, Mohawks often traded with resident Dutch and English colonists. Between 1630 and 1640, an estimated twenty thousand European immigrants settled in the region—including many children. Hence, the colonial context had changed significantly in the early seventeenth century: many more people lived on what was previous unsettled buffer zones, reducing natural resources and increasing contact between human communities; and many European children as well as Indigenous communities were vulnerable to smallpox, which erupted in 1633.[5]

The Spanish effort to create their “La Florida” colony, between 1565 and 1706, also significantly disrupted Indigenous life. Nations such as the Guales, living on what we would today call the Georgia coast, as well as the Timucuas and Apalachees, of modern-day northern Florida, lived in dispersed towns eating a diverse array of foods, including cultivated maize (corn). However, Spanish colonizers implemented a tribute (taxation) system that required Indigenous male labor and food payments to support the Spanish. At the same time, the Spanish forcibly concentrated Indigenous populations around missions to assimilate them into Spanish culture and Christianity while wielding more control over labor. All of this had profound effects on Indigenous physical and mental health. Diet became less varied, more corn-centric, and more iron deficient (among other problems). Very hard labor tributes fell disproportionately on Indigenous men, including traveling long distances to deliver corn throughout the colony. Extended male absences also prevented births, limiting Indigenous population growth. In the mission centers, every aspect of spiritual and cultural life was under attack, along with more concentrated settlement in poorer health, which enabled outbreaks of disease. These combined disruptions decimated Guale, Timucua, and Apalachee populations.[6]

A significant part of European North American colonization also involved enslavement of Indigenous peoples. Though Indigenous Americans—like all people around the world—had long histories of captive-taking in warfare and violence toward enemies, nothing equivalent to European plantation slavery existed locally. Europeans integrated into established Indigenous exchange networks, trading wool cloth, metal goods, horses, and guns (among other things) in exchange for Indigenous food, hides, and captives. Whereas captive-taking in an Indigenous community was small-scale, served as victory over enemy, and often resulted in adoption into the captor’s nation, Europeans saw captives as chattel slaves—a permanent laboring class legally defined as property.[7]

The impact on Indigenous life was disastrous. Indigenous enemies attacked each other more often in search of more captives, and this warfare also led to population loss. Thousands moved into more concentrated and fortified settlements. Food provision, including farming and hunting, was compromised. Increasingly, colonists attacked Indigenous communities directly in efforts to gain slaves and land. In what the English called Virginia and South Carolina, this was the reality for much of the seventeenth century. South Carolina colonists enslaved an estimated 50,000 Indigenous peoples from 1670-1715. English settlements gradually included many children and more enslaved Africans, and both groups were susceptible to European diseases. In this context, the Great Southeastern Smallpox Epidemic commenced in 1696, ravaging the colonial African, European, and especially the Indigenous populations for the next four years from Virginia to the Gulf coast, producing “a disaster like nothing that had ever happened to the [Mississippi] river valley’s inhabitants.” Again, Indigenous life changed significantly in the context of English demands for land and slaves, undermining health that then made communities vulnerable to disease.[8]

Nevertheless, colonialism by different empires impacted Indigenous communities differently. For instance, the Osage, whose towns were located in what we now call central and western Missouri, dominated exchange with the French in the eighteenth century and controlled the regional flow of goods. The Osage people flourished in every sense. The rise of the United States of America, however, dramatically altered Osage prosperity. In the nineteenth century, refugee Indigenous nations from the east, displaced by the expanding U.S. population, encroached on Osage lands, increasing competition over natural resources. The Louisiana Purchase (1803) and a treaty with the federal government several years later signaled that U.S. settlers would invade the Osage homeland next. By the 1820s, Missouri had achieved statehood, missionaries arrived to dismantle Osage culture, and another treaty confined the Osage to a reservation in what is today southern Kansas. All removals involved death because not only was mental health assaulted with the alienation from homeland, but food provision was compromised since crops could not be planted and harvested in two distant locations, not to mention the disruptions to gathering, hunting, and trading. The new Osage reservation was inhospitable to agriculture; hence, it took five years to determine where to build towns and try to grow their crops. In the meantime, they experienced significant food instability and malnutrition. The 1820s and 1830s, not surprisingly, coincided with outbreaks of numerous epidemics among the Osage, killing hundreds.[9]

These challenges worsened for the Osage in the 1850s, when Congress created Kansas territory and opened the region to U.S. settlement. The Osage experienced rapid settler invasion on the reservation. Settlers took land, stole Osage horses and whatever produce ripened in Osage fields, they moved into or dismantled Osage houses, and they robbed Osage graves—where the deceased were buried with goods, including food, needed to travel to the afterlife. Eventually settlers created local militias with the governor’s support to terrorize the Osage into moving out of Kansas. Thousands were dying now from measles, smallpox, typhoid fever, and whooping cough. The population had been 10,000-12,000 in Missouri before removal, but by 1860 the Osage population was an estimated 3,500. “The Osage did not die from accidentally introduced ‘virgin’ soil epidemics. They died because U.S. colonization, removal policies, reservation confinement, and assimilation programs severely and continuously undermined physical and spiritual health. Disease was the secondary killer.”[10]

For those who have been taught that Indigenous peoples were virtually “defenseless” against European diseases, another underlying assumption is that Indigenous communities either mounted no response to diseases or what they did was counterproductive, and supposedly all of this directly challenged their worldview and spiritual beliefs. This is also false. Prior to colonization, Indigenous Americans—like all the world’s peoples—had experience with treating and understanding local disease and illness. Nations such as the Cherokee, Creek (or Muskogee), Choctaw, and Chickasaw in response to the Great Southeastern Smallpox Epidemic and outbreaks thereafter extended their established views of disease to incorporate the new epidemics. They relied on experienced healers, and their medical and spiritual power, while observing ritualized quarantine and limiting contact with colonial settlements. In more extreme circumstances of disease and population loss, Indigenous nations, such as the Awahnichi (of Yosemite Valley) acted as they had for millennia, moving and joining with others, either temporarily or permanently. Focused on improving quality of life and sustaining their nations into the future, these Indigenous communities, did not abandon their identity, but they did—as they had since long before colonization—adapt to new circumstances.[11] 

Now that scholars have established that the context of colonization is critical to understanding Indigenous Americans’ experience with disease, some have started to investigate how this connects to genocide. Many rely on the United Nation’s definition where genocide means “intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such: a) killing members of the group; b) causing serious bodily or mental harm to members of the group; c) deliberately inflicting upon the group conditions of life calculated to bring about its physical destruction in whole or in part; d) imposing measures intended to prevent births within the group; e) forcibly transferring children of the group to another group.”[12]

The crux of applying genocide typically rests on intent. Accidental newly introduced European diseases seemed to lack “intent to destroy.” But the last thirty years of scholarship necessitates reevaluation. When the Spanish in La Florida required Guale, Timucua, and Apalachee men to conduct extreme physical labor that kept them away from their families and homes, did that constitute an intent to prevent births? It did prevent births. What should one expect will happen to a community’s food provision and fertility when most of the able-bodied men are absent for extended periods at the behest of Spanish colonizers? English colonial settlements displaced Indigenous communities and undermined their food provision, eventually followed by epidemics. We know the English intended to permanently settle on Indigenous lands and profit from Indigenous enslaved labor. So, was this “deliberately inflicting upon the group conditions of life calculated to bring about its physical destruction”? For the Osage in Kansas, when U.S. settlers were stealing Osage horses, living in Osage houses, eating Osage crops, and defiling Osage graves, what was their intent? “Serious bodily or mental harm” certainly seems the goal.[13]

And there are more recent examples. Boarding schools were places of death for Indigenous youth well into the twentieth century. Hard labor and strenuous regimentation combined with the psychological assaults of separation from family and community, as well as curriculum that attempted to exterminate Indigenous culture, identity, and language. Inadequate diets caused malnutrition, medical care was limited, and overcrowding common. Some reservation communities lost more than half of the students sent to schools. Was this genocide? The professed intent at boarding schools was cultural destruction. And it caused death. Repeatedly. Children faced “serious bodily or mental harm” and they were transferred—often forcibly—from one group to another.[14]

As historian and citizen of the Peoria Tribe of Indians of Oklahoma Elizabeth N. Ellis argues, “for American Indian people, how we tell these histories matters.” Not only for our understanding of the past, but also in terms of how Indigenous nations “exercise rights and sovereignty in the present.”[15] The recent scholarship on the role of disease in European colonization of the Americas is slowly starting to trickle into other sources. However, combatting the entrenched story of “virgin soil” epidemics is difficult. Why is that?

Alfred W. Crosby, Jr., architect of the “virgin soil” understanding of disease admitted in the thirtieth anniversary edition of one of his influential books, “Big questions can, of course, lead to over-simplified answers. I probably did that with my telling of the arrival and first spread of smallpox in America, which, I indicated, led ipso facto to European triumph.”[16]

But it’s more than that. For some, a focus on assumed accidental disease deaths “shifted blame off Europeans” and onto blameless germs.[17] In many ways, this is comforting because “narratives of the inevitable demise and vanishing of Native peoples fit seamlessly within our national mythos of American expansion into an untamed and empty wilderness.”[18] By obscuring how the actions of colonizers negatively impacted Indigenous peoples’ lives and health in the past, it is likewise easier to ignore those same factors in the present.[19]

During the COVID-19 pandemic in the U.S., for example, Native Americans’ risk of death was 2.1 times higher than White Americans, attributed to severe health care inequities, partially tied to a chronically underfunded federal Indian Health Service, along with other traumatic and racist colonial legacies. “Native American people had the steepest decline in life expectancy of any racial or ethnic group in the USA, from age 71.8 years to 65.2 years, between 2019 and 2021; the life expectancy gap between the US non-Hispanic White population and the Native American population in 2021 was 11.2 years.”[20] Significantly, though, Indigenous researchers found that “from the beginning of the Covid-19 vaccination campaign in the United States, the non-Hispanic American Indian and Alaska Native (AI/AN) population has continuously had the highest first-dose and full vaccination rates of any racial or ethnic group,” which is vital to protecting Indigenous populations as the world lives with COVID-19 into the future. Tribal governments and Indigenous community-based organizations were central to vaccination success, nimbly and innovatively promoting vaccination in culturally appropriate ways. In other words, tribal sovereignty had a direct positive impact on Indigenous health and surviving disease.[21]

A group of healthcare workers are on a sled in Alaska, ready to deliver COVID-19 vaccines.

Healthcare workers from Maniilaq Association, which manages health and socialservices for twelve federally recognized tribes in Northwest Alaska, traveled via charteredairplane and sleds pulled by snowmachine into the village of Shungnak in Dec. 2020 to provideCOVID-19 vaccinations. Photo from Nathaniel Herz, “In rural Alaska, COVID-19

vaccines hitch a ride on planes, sleds and water taxi,” Alaska Public Media, Jan 18, 2021,

https://alaskapublic.org/2021/01/08/in-rural-alaska-covid-19-vaccines-hitch-a-ride-on-planes-sleds-and-water-taxi/, accessed 9/11/2023.

For at least the next generation, historians must emphatically and repeatedly contextualize epidemics in Indigenous communities to overcome the prevalence of the inaccurate “diseases spread like wildfire” among “defenseless Indians” narrative. There is an abundance of nuanced research to rely on that shows how colonizers disrupted Indigenous lives, and then diseases struck. We must also confront why we, along with the public, have been so easily seduced by simplistic stories of disease. Inequities of wealth, health, and power today are the descendants of past inequities. Do the stories we tell and the arguments we teach reflect the power of colonial hierarchies in our modern life? And what about genocide? Roxanne Dunbar-Ortiz contended that many “refuse to accept that the colonization of America was genocidal by plan, not simply the tragic fate of populations lacking immunity to disease. In the case of the Jewish Holocaust, no one denies that more Jews died of starvation, overwork, and disease under Nazi incarceration than died in gas ovens, yet the acts of creating and maintaining the conditions that led to those deaths clearly constitute genocide.”[22] We must also emphasize resilience. As Kathleen L. Hull has argued, “issues of health and survival are much more complex than we are often led to believe. It is a disservice to both descendant communities and our collective heritage and history to ignore the myriad factors that contributed to when and how Native peoples confronted such challenges to survival and how groups, if not many individuals, often endured.” And as we learned with COVID-19, resilience is most effectively advanced through supporting tribal sovereignty.[23]


Tai S. Edwards is a history professor and the director of the Kansas Studies Institute at Johnson County Community College in the Kansas City metro area. She is the author of numerous works, including Osage Women and Empire: Gender and Power (2018) and has collaborated on many projects including rematriating Iⁿ‘zhúje‘waxóbe (Sacred Red Rock) to the Kaw Nation as well as preservation of the historic Wyandot, African American, and abolitionist town, Quindaro, in Kansas City, Kansas.


[1] Tai S. Edwards, “The ‘Virgin’ Soil Thesis Cover-up: Teaching Indigenous Demographic Collapse,” in Understanding and Teaching Native American History, ed. Kristofer Ray and Brady DeSanti (2022), 31; David S. Jones, “Death, Uncertainty, and Rhetoric,” in Beyond Germs: Native Depopulation in North America, ed. Catherine M. Cameron, Paul Kelton, and Alan C. Swedlund (2015), 16-49.

[2] Paul Kelton, Alan C. Swedlund, and Catherine M. Cameron, introduction to Cameron, Kelton, and Swedlund, Beyond Germs, 3.

[3] Edwards, “’Virgin’ Soil Thesis Cover-Up,” 30, 37.

[4] Paul Kelton, Epidemics and Enslavement: Biological Catastrophe in the Native Southeast, 1492-1715 (2007), 49-50.

[5] Dean R. Snow and Kim M. Lanphear, “European Contact and Indian Depopulation in the Northeast: The Timing of the First Epidemics,” Ethnohistory, 35 (Winter, 1988), 15-33.

[6] Clark Spencer Larsen, “Colonialism and Decline in the American Southeast: The Remarkable Record of La Florida,” in Cameron, Kelton, and Swedlund, Beyond Germs, 74-98.

[7] Catherine M. Cameron, “The Effects of Warfare and Captive-Taking on Indigenous Mortality in Postcontact North America,” in Cameron, Kelton, and Swedlund, Beyond Germs, 174-197.

[8] Kelton, Epidemics and Enslavement, 101-159.

[9] Tai S. Edwards, “Disruption and Disease: The Osage Struggle to Survive in the Nineteenth-Century Trans-Missouri West,” Kansas History: A Journal of the Central Plains, 36 (Winter, 2013-2014) 218-233.

[10] Tai S. Edwards, Osage Women and Empire: Gender and Power (2018), 94-99, 106-110, 121-122.

[11] Paul Kelton, “Avoiding the Smallpox Spirits: Colonial Epidemics and Southeastern Indian Survival,” Ethnohistory, 51 (Winter 2004): 45-71; Paul Kelton, Cherokee Medicine, Colonial Germs: An Indigenous Nation’s Fight against Smallpox, 1518-1824 (), 59-101; Kathleen L. Hull, “Quality of Life: Native Communities Within and Beyond the Bounds of Colonial Institutions in California,” in Cameron, Kelton, and Swedlund, Beyond Germs, 222-248.

[12] United Nations: Office on Genocide Prevention and the Responsibility to Protect, “Convention on the Prevention and Punishment of the Crime of Genocide,” Dec. 9, 1948, https://www.un.org/en/genocideprevention/genocide.shtml, accessed Aug. 28, 2023.

[13] Tai S. Edwards and Paul Kelton, “Germs, Genocides, and America’s Indigenous Peoples,” Journal of American History, 107 (June, 2020), 52-76.

[14] David Wallace Adams, Education for Extinction: American Indians and the Boarding School Experience, 1875-1928 (2020), 135-149; George E. Tinker, Missionary Conquest: The Gospel and Native American Cultural Genocide (1993), 5-8.

[15] Elizabeth N. Ellis, The Great Power of Small Nations: Indigenous Diplomacy in the Gulf South (2023), 11.

[16] Alfred W. Crosby, Jr., The Columbian Exchange: The Biological and Cultural Consequences of 1492 (2003), xxii.

[17] Jones, “Death, Uncertainty, and Rhetoric,” 24.

[18] Ellis, The Great Power of Small Nations, 231.

[19] Edwards, “The ‘Virgin’ Soil Thesis Cover-up,” 39.

[20] Naomi R. Lee, etal., “Infectious diseases in Indigenous populations in North America: learning from the past to create a more equitable future,” The Lancet Infectious Diseases, 2023, https://www.sciencedirect.com/science/article/pii/S1473309923001901, accessed 8/23/2023.

[21] Raymond Foxworth, etal., “Covid-19 Vaccination in American Indians and Alaska Natives — Lessons from Effective Community Responses,” The New England Journal of Medicine, 385 (Dec. 23, 2021), https://www.nejm.org/doi/full/10.1056/NEJMp2113296, accessed 8/23/2023; Rachel Hatzipanagos, “How Native Americans launched successful coronavirus vaccination drives: ‘A story of resilience,’” Washington Post, May 26, 2021, https://www.washingtonpost.com/nation/2021/05/26/how-native-americans-launched-successful-coronavirus-vaccination-drives-story-resilience/?itid=sr_1, accessed Sept. 6, 2023.

[22] Roxanne Dunbar-Ortiz, An Indigenous Peoples’ History of the United States (2014), 41-42.

[23] Hull, “Quality of Life,” 222.