Native American cultures, genetics, nutrition, and ways of life co-evolved with their natural systems through thousands of years. This process has resulted in seamless eco-cultural systems of humans, plants, animals, rivers, landforms, and air sheds. These eco-cultural systems have also provided its peoples with unique and valid environmental management science that has sustained the peoples and their resources for thousands of years. This resource-based perspective could form the basis of environmental justice risk assessment methodology in Indian Country. Cumulative impacts to tribal cultures are a combination of pre-existing stressors (existing conditions or co-risk factors) and any other contamination or new activity that affects environmental quality. Characterizing risks or impacts in Indian Country entails telling the cumulative story about risks to trust resources and a cultural way of life. Equity assessments could also be performed in a way that describes these systems-level cumulative risks/impacts. This requires improvements in metrics based on an understanding of the unbreakable ties between people, their cultures, and their resources. Specific recommendations are presented for performing equity assessments in Indian Country and for developing a Risk Ethics discipline.