This article argues for child welfare to be named a social determinant of health for First Nations and Métis peoples.For decades, First Nations and Métis children have been overrepresented in child welfare (CW) systems across Canada. Despite governmental and public awareness of the devastating impacts on Indigenous children and families from CW policies and practices, CW systems across Canada apprehend Indigenous children at alarming rates, and a significant number of Indigenous children are raised outside of their families, culture, and communities in non-Indigenous foster and adoption placements. This paper examines whether the state is fulfilling its mandate to be a “wise and compassionate parent” based upon a social determinants of health perspective. We consider specifically the impacts of foster home overcrowding, multiple foster placements, and the micro-level “day to day” experiences of Indigenous children and parents.