A/HRC/57/47 institutions, all of which have eroded the foundation of Indigenous societies. This historical context has contributed to higher rates of poverty, malnutrition and exposure to environmental hazards, all of which are significant risk factors for being born with or acquiring impairments that, in interaction with barriers, result in disability. Structural racial discrimination further exacerbates these challenges by creating barriers to accessing essential services and resources. Indigenous persons with disabilities often face double discrimination: first, as members of a community of Indigenous Peoples; and second, on the basis of disability. This intersectional marginalization leads to inadequate health-care services, poor educational outcomes and limited employment prospects. 16. In Australia, the number of persons with disabilities in the Indigenous population, at almost 4 in 10 (38 per cent), is nearly three times higher than in the general population. 5 Similarly, in the United States of America, people who identify as Native American are 50.3 per cent more likely to have a disability than the national average.6 In Greenland, nearly one fifth of the population identifies as a person with a disability. 7 In Guatemala, about half of the population self-identifies as Maya. 8 However, persons with disabilities are not consistently included and counted in mainstream data collection. 9 The Government of Guatemala has acknowledged the evolving nature of disability and the interaction of an impairment with societal barriers among Indigenous Peoples in Guatemala. 10 17. In addition to historical and structural factors such as colonization, as well as ongoing systemic discrimination, dangerous working conditions, environmental conflicts, pollution from extractive industries and a lack of access to health care and services are significant contributors to acquiring an impairment that, in interaction with attitudinal and environmental barriers, hinders the full and effective participation in society on an equal basis with others and results in disability. 18. In many States, Indigenous persons with disabilities encounter significant challenges due to extreme poverty and the location of services away from remote villages. They also face disparities in development indicators, intensifying their vulnerability. 11 Indigenous Peoples across the world are three times more likely to live in extreme poverty than the general population.12 Poverty can be a cause of acquiring impairments because people in poverty do not have access to adequate health care or nutrition. 19. Acknowledging the root causes of high rates of acquiring an impairment that, in interaction with attitudinal and environmental barriers, hinders the full and effective participation in society on an equal basis with others and results in disability among Indigenous Peoples is not intended in any way to stigmatize, but is part of ensuring respect for the environmental and health-related human rights of Indigenous Peoples. In addition, since Indigenous Peoples are particularly affected by high rates of impairment, it is important to address the root causes of such a disproportionate impact under article 12 of the International Covenant on Economic, Social and Cultural Rights. 20. Indigenous Peoples experience high rates of acquired impairments owing to barriers in accessing appropriate education, leading to poor socioeconomic outcomes.13 For example, a low level of educational achievement often causes young adults to remain employed in dangerous industries in which workplace injuries are common and in which they are more likely to acquire impairment.14 5 6 7 10 11 12 13 14 GE.24-12379 Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey, 2018/19. See https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/LTSSTA-Center/info/ai-an-age-and-disability. A/HRC/54/31/Add.1, para. 84. 8 Submission from Guatemala. 9 See https://unsdg.un.org/latest/blog/count-me-working-together-disability-inclusion-guatemala. Submission from Guatemala. Ibid. A/C.3/77/SR.16, para. 34. Submission from the Assembly of First Nations. Submission from Canada. 5