Traditionally, the Míkmaq enjoyed an interconnected relationship with the land, harvesting what they needed from the earth and the ocean, guided by the concept of Netukulimk, the practice of sustainability. Upon the arrival of European settlers, new trade practices were introduced, and what was once plentiful was quickly depleted. Although the original inhabitants were assured that their lands would be protected by agreements and treaties, these assurances proved to be false, and the traditional relationship with the land was threatened, as the Míkmaq—presaging the fate of most Indigenous Peoples in Canada—were dispossessed of their historical lands and forced to live on reserves; many of them far away from the environments to which they had had biological and spiritual ties. Land is central to our understanding of current Indigenous health issues; centering around how the Míkmaq traditionally employed land and resources, what changes in that relationship were brought about by colonization, and how their removal to reserves influenced their relationship vis-à-vis their environment. In addressing the ways that land policies, post-first contact, were developed and implemented over time, it is possible and necessary to juxtapose that history with the story of the forced mobilization of the Míkmaq, and examine the effects that the dispossession of land had upon their livelihood and economic activity. Informed by McGibbon's paradigm of the cycles of oppression, Boyer's study of the determinants of health is used as a lens to undertake an historical analysis of the habitation patterns of the Míkmaq who formerly resided in Sikniktuk (currently concentrated in Elsipogtog, once known as Big Cove Reserve and Richibucto Reserve #15). This critical ethnography argues that while dispossession from traditional lands and the subsequent decline of the Míkmaq population constitute a profoundly negative social determinant of health, the Elsipogtog community has responded to these conditions with resilience and perseverance.