David Wilkinson argues that the impact of settler presence and activity on Aboriginal health status has been profound. In common with similar impacts in other settled countries worldwide, the dislocation and disruption of a 'traditional' way of life, coupled with immersion in an inherently unhealthy 'settled' way of life, has meant Aboriginal people now experience very poor health status. This paper examines the extent and magnitude of this differential, its causes and, most importantly, what can be done to address it.