The concept of health governance has substantial implications for Aboriginal health along several dimensions. In this issue, we consider health governance to refer to the extent that individuals or communities have control over the conditions that impact their health. There is increasing recognition that control is an important determinant of health independent of poverty, physical environment and other social determinants of health outcomes. The widely referenced Whitehall studies have provided (fundamental or essential) evidence to suggest that individuals who feel they have a higher level of control over the conditions of their work life have better health regardless of income levels. In Canada, M.J. Chandler and C. Lalonde have produced provocative evidence that lower suicide rates are found in First Nations Peoples in British Columbia who exhibit higher levels of cultural continuity, which is defined as a higher level of sustained control over the cultural and political processes in the community. Although additional work is needed to confirm these findings, this evidence suggests self-determination and local governance in First Nations communities is related in important ways to improved health outcomes.