THE UNNATURAL HISTORY OF DISEASE The health problems Native Americans are confronting today did not arise out of an historical vacuum. Diseases and ill health have a history. Health levels are linked to the social, political, and economic forces present at any historical moment. Thus, in order to understand some of the present day factors determining Native American health levels, it is imperative to examine the historical context from which these health patterns emerged. The medical history of Native Americans since European contact can be characterized as an “unnatural history of disease’’-unnatural because the epidemiology of Native American people changed under the hegemony of European contact. Native Americans, from the sixteenth through the mid-twentieth century, experienced a new set of afflictions which decimated their populations. Epidemics such as smallpox, rubella, influenza, malaria, yellow fever, and cholera ravaged Native American societies, creating societal disorganization. It is not surprising that these epidemic episodes coincided with European expansion and development of the frontier.