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Tag: Native American Heritage Month

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Native American Heritage Month occurs in November every year. The month “is a time to celebrate the traditions, languages and stories of Native American, Alaska Native, Native Hawaiian, and affiliated Island communities and ensure their rich histories and contributions continue to thrive with each passing generation.” (U.S. Department of the Interior, n.d.) Many governmental agencies and health organizations share resources that discuss the history of Indigenous groups within the United States. 

Native Voices: Native Peoples’ Concepts of Health and Illness is a virtual exhibition that “explores the interconnectedness of wellness, illness, and cultural life for Native Americans, Alaska Natives, and Native Hawaiians.” (National Library of Medicine, n.d.) The exhibit is split into five sections:

Along with the five sections, a collection of interviews touches on themes such as community, healing, nature and more. 

The virtual exhibit has educational resources that are useful in a classroom setting or for personal use. Their suggested readings bibliography features works by Native Americans or works that focus exclusively on Native Americans. 

The Office of Minority Health (OMH) provides current information about the health of indigenous communities. Their Population Health Data has census reports, links to additional health websites and statistics about indigenous communities. The health data is separated across multiple categories such as asthma, cancer, immunizations and other health concerns. Finally, the OMH’s American Indian & Alaska Native Health in the United States pathfinder guides users to appropriate resources such as journals, government websites and research articles. 

This month is an excellent time to explore the concerns and needs of American indigenous communities. The readings and resources listed above provide a glimpse of the long history and unique culture of American indigenous nations. 

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Photo by EVG Kowalievska

The United States has a history of assisting vulnerable populations with community needs, often with varying degrees of success. The Indian Health Service (IHS), part of the Department of Health and Human Services, is one such government organization that provides healthcare for millions of Indigenous people and since its inception, the service has positively impacted federally recognized Native nations despite budgetary constraints. The Service employs physicians, nurses, dentists and other healthcare professionals to meet the healthcare needs of Indigenous populations and the organization sponsors professional opportunities for Indigenous students at both the undergraduate and graduate levels who express an interest in entering the healthcare field.

The Indian Health Service was created in 1955 and was born out of a long history of the United States government providing assistance to Indigenous nations. “The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article 1, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders.”(Warne & Frizzell, 2014, p. S263) The federal government would send military physicians to Indigenous communities in an effort to address the spread of diseases such as smallpox. Unfortunately the government spent far less money on the healthcare of Indigenous people in comparison to members of the military. In 1880, the Commissioner of Indian Affairs, Thomas J. Morgan requested more funding to cover expenses and he “calculated the disparity in resources, finding that the Army spent $21.91 per soldier and the Navy $48.10 per sailor, while the government only appropriated $1.25 per Indian patient.” (Trahant, 2018, p. 118)

In 1911 President William Howard Taft urged Congress to raise the salary of healthcare workers employed in the Indian Service. But the history of underfunding Indigenous healthcare continued. When the Bureau of Indian Affairs opened a health division in 1921, the system suffered from poor funding, unsanitary facilities and inadequate supplies which placed a strain on the quality of care provided. In 1955, Congress transferred the health programs away from the Bureau of Indian Affair to the newly formed Indian Health Service. They also raised the service’s budget from $10 million to $17.7 million a year. Finally in 1976, “Congress proposed a sweeping new authorization for Indian health programs. The Indian Health Care Improvement Act…called on Congress to appropriate at least $1.6 billion in new funding for Indian health, spending resources on improving staffing, facilities, access to care for urban Indian populations, and, for the first time, opened up Medicare and Medicaid revenue.” (Trahant, 2018, p. 119)

The Indian Health Service’s headquarters is located in Rockville, Maryland and has twelve service areas located across the country. The current head of the service is Roselyn Tso, an enrolled member of the Navajo Nation. Tso began working for the Service in the 1980s and has worked in many different capacities, including serving as the director of the Indian Health Service Navajo Area in 2019. The Indian Health Service provides access to hospitals, health centers, dental clinics and behavioral health facilities to Indigenous communities in the twelve service areas. The organization also offers healthcare education so people can improve their quality of health outside of regularly scheduled appointments. The Indian Health Service is one of the few federal organizations that prioritizes Indigenous applicants during the job search process and they also host funding opportunities for students interested in a career in healthcare. Scholarships are available for undergraduate, graduate and preparatory school students. The Indian Health Service also offers an extern program where participants earn valuable, hands-on skills while working in IHS facilities. 

While the organization continues to suffer from poor funding in comparison to other federal organizations, the Indian Health Service has improved the overall health of their patients. For example, the infant mortality rate for Indigenous communities has drastically decreased since 1955 and “The Centers for Disease Control and Prevention reported that, in the United States from 2004 to 2008, 84 percent of American Indians and Alaska Natives have a ‘usual place for health care.’” (Trahant, 2018, p. 120) Besides the lack of adequate funding, another criticism of the Indian Health Service is the organizations’ lack of focus on Indigenous people who live in urban areas.  Over the years, the IHS has sought  to provide resources to patients in urban areas,  and to meet the needs of over 2 million Indigenous patients.

The Indian Health Service was born out of the numerous treaties, legally binding agreements and promises made between the US federal government and the governments of Indigenous nations such as the 1832 treaty between the War Department and the Winnebago Tribe in Wisconsin in which the federal government promised two physicians in exchange for land (Trahant, 2018). The healthcare and administrative workers in the IHS search for creative solutions to meet the pressing healthcare needs of their patients. And by offering scholarships and externships, the organization aims to tackle the healthcare industry’s lack of Indigenous workers. The Indian Health Service’s mission is “To raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level” and by fulfilling this mission, the IHS provides an example for other healthcare organizations committed to addressing health disparities in other vulnerable and underserved communities.

References:

Indian Health Service. (n.d.). Indian Health Service: The Federal Health Program for American Indians and Alaska Natives. https://www.ihs.gov/

Marcinko, T. (2016, November 13). More Native American Doctors Needed to Reduce Health Disparities in Their Communities. AAMCNEWS. https://www.aamc.org/news-insights/more-native-american-doctors-needed-reduce-health-disparities-their-communities. 

Warne, D. & Frizzell, L.B. (2014). American Indian Health Policy: Historical trends and contemporary issues. American Journal of Public Health, 104(3), S263-S267. https://doi.org/10.2105/AJPH.2013.301682

Trahant, M.N. (2018). The story of Indian health is complicated by history, shortages, & bouts of excellence. Daedalus, 147(2), 116-123. https://doi.org/10.1162/DAED_a_00495

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Headshot of Michael E. Bird
Photo credit: Leadership Academy for the Public’s Health

In an effort to remain accountable to communities who have been negatively impacted by past and present medical injustices, the staff at Himmelfarb Library is committed to the work of maintaining an anti-discriminatory practice. We will uplift and highlight diverse stories throughout the year, and not shy away from difficult conversations necessary for health sciences education. To help fulfill this mission, today's blog post celebrates the contributions of Native American Michael E. Bird to the field of public health.

Michael E. Bird, a Santo-Domingo/Kewa Pueblo Indian from New Mexico, has more than 25 years of experience working in public health and with Native American populations. After growing up in New Mexico, California, and Utah, Bird earned his bachelor’s degree in anthropology and a master of social work (MSW) degree from the University of Utah (Berkeley Public Health, 2020). Bird worked as a medical social worker prior to completing his master of public health at the University of California’s Berkeley School of Public Health in 1983 (Berkeley Public Health, 2020).  

Cover of the American Journal of Public Health, Volume 104, No. S3 (June 2014).

Bird was the first Native American to serve on the National Policy Council of AARP, as well as the first Native American and social worker to become President of the American Public Health Association (APHA) (University of Utah College of Social & Behavioral Science (UT CSBS), n.d.). During his time as APHA President, the APHA’s journal, the American Journal of Public Health, published a supplemental issue focused on Native public health - a historic first for the journal.

Bird has also served as the executive director of the National Native American AIDS Prevention Center, and has worked with the Indian Health Service (IHS) for 20 years (UT CSBS, n.d.). Additionally, he has served as President of the New Mexico Public Health Association and has been a board member of numerous organizations including the Kewa Pueblo Health Corporation, and the American Indian Graduate Center among others (UT CSBS, n.d.).

Bird became aware of the public health issues facing Native Americans while working at the Santa Fe Indian hospital. He spoke of this experience in an interview with Berkeley Public Health in which he explained “ [I] wasn’t able to have the kind of impact I wanted to have, and that no matter how good I was, or what I did, that it was sort of a revolving door for patients. … That lack of opportunities for Native people was contributing to their health conditions.” (Berkeley Public Health, 2020). Bird went on to explain that working for the Indian Health Service made him even more aware of the constraints of working with an underfunded bureaucratic system that “didn’t provide enough support and leadership, and was not engaging tribal communities in a respectful, collaborative manner” (Berkeley Public Health, 2020).

In July 2020, Bird spoke about the disproportionate effect of COVID-19 on Native Americans during this same interview with Berkeley Public Health. Conducted early on during the COVID-19 pandemic, Bird stated that in New Mexico “Native Americans make up 11 percent of the general population but they make up 50 percent of the COVID-19 cases” (Berkeley Public Health, 2020). Bird explained that the Pueblo tribes and Navajo Nation, both significantly impacted by the pandemic, had high poverty rates and marginalized populations with people living without “adequate housing, water, or electricity, and COVID just compounds all these conditions. It’s not just obesity, it’s what created obesity” (Berkeley Public Health, 2020). 

In the July 2021 issue of Nation’s Health, Bird outlined some actions that can be taken to improve health inequities among Native American populations. “First, we need to ask ourselves how we got here, and what we’re willing to do to move in an ethical and humane direction” (Bird, 2021). He further explains that committing to “involve communities whose voices have been largely absent from the rooms where power and policies are created, which determine our future” is essential if we want to move forward (Bird, 2021).

In October 2020, Bird presented a session titled “Owning Historical Trauma: A Precursor to Strengthening Public Health” at the APHA Virtual Annual Meeting. Watch the following video to hear Bird’s thoughts on this issue:

“I think the other thing is that one of the polite terms that’s used is “comorbidities” for communities. It’s a polite way of really not addressing the real issue. The real issue is historical trauma, the real issue is poverty, the real issue is racism. … this is important because people don’t know the history of this country, particularly when it comes to native populations. People don’t understand the context, the nature of disparities, the nature of poverty, racism, and how history is tied to all of that.” ~ Michael E. Bird

(American Public Health Association, 2020).

Interested in learning more about Native American Health? Check out the Native Health Database. Take a look at our blog post about this resource to learn more!

References:

American Public Health Association (APHA). (2020, October 24). Michael Bird, MPH, MSW - National Consultant, National Policy Council for AARP . https://www.youtube.com/watch?v=OmRgzfKKe9M

Berkeley Public Health. (July 23, 2020). How can American get Native health right? A conversation with Berkeley Public Health alumnus Michael E. Bird. https://publichealth.berkeley.edu/news-media/school-news/how-can-america-get-native-health-right/

Bird, M.E. (2021). Then & now: 20 years later, has the American Indian and Alaska Native health improved? Nation’s Health, 51(1), 8.

University of Utah College of Social & Behavioral Science (UT CSBS). (n.d.). Michael E. Bird. CSBS Alumni, Emeriti, and Friends Spotlight. https://csbs.utah.edu/alumni-spotlights/m-bird.php

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Susie Walking Bear Yellowtail (Women's History Matters)

In an effort to remain accountable to communities who have been negatively impacted by past and present medical injustices, the staff at Himmelfarb Library is committed to the work of maintaining an anti-discriminatory practice. We will uplift and highlight diverse stories throughout the year, and not shy away from difficult conversations necessary for health sciences education. To help fulfill this mission, today's blog post examines the life and activism of Susie Walking Bear Yellowtail.

Susie Walking Bear Yellowtail was a Native American nurse who consistently advocated for better access to quality, culturally sensitive healthcare and during her decades long medical career, she documented and recounted stories of medical abuse that Native Americans frequently experienced when visiting hospitals or non-Native doctors. Yellowtail was one of the first Native American registered nurses and the first registered nurse from the Crow people. Her work as an activist paved the way for other medical professionals who sought to end harmful practices that frequently impacted lower-class families and people of color.

Yellowtail was born on January 27, 1903 on the Crow Indian Reservation in Montana. She was orphaned at a young age, but lived with an aunt who took care of Yellowtail and her sister. Like many young Native children, Susie Yellowtail attended an Indian boarding school until she met the Baptist missionary, Frances Shaw. Yellowtail traveled with Shaw to a Baptist convention in Denver, before moving to Oklahoma to complete her education at the Bacone Indian School. When Frances Shaw married and became Mrs. Clifford Fields, Yellowtail once again moved to the East where she lived with the Fields family. During this time, Susie Yellowtail enrolled in Northfield Seminary. Mrs. Fields paid for the tuition fees, but to afford her room and board, Yellowtail worked as a nanny and maid for the Fields family. Eventually she left the seminary and instead enrolled in a nursing program at Franklin County Memorial Hospital and completed her training at the Boston City Hospital School of Nursing. She received her degree in 1927 and worked in several different positions before returning to the reservation where she was born.

Working as a nurse for the Indian Health Service’s run hospital, Yellowtail witnessed firsthand the mistreatment many Crow people experienced during their appointments. She “documented instances of Indian children dying from lack of access to medical care, Indian women being sterilized without consent, and tribal elders unable to communicate their health concerns to doctors.” (Women's History Matters) Yellowtail sought to provide better treatment for her community and was vocal with her criticisms of the non-Native doctors, nurses and medical professionals who worked in the hospital. She blended her Crow culture and traditions with her medical education to care for Native patients who were nervous around the hospital staff or unable to access the hospital and its services. In 1929, Susie Walking Bear married Thomas Yellowtail and the two became major leaders on the reservation.

Thomas and Susie Yellowtail (Women's History Matters)

Susie Walking Bear Yellowtail served as a member of several reservation advisory committees and this eventually led to President John F. Kennedy appointing her to the Surgeon General’s Advisory Committee on Indian Health. She was reappointed to this position by both the Johnson and Nixon administrations. In this role, Yellowtail traveled to other Native American reservations and documented Native Americans’ experiences with visiting their hospitals. Almost immediately, she noticed a similarity in stories and used this information to create recommendations that would improve not only the relationship between Native Americans and health professionals, but also address years of harm that went unchecked. Susie Yellowtail continued her work for decades and died on December 25, 1981.

Yellowtail received recognition for her work both during her lifetime and after her passing. She was awarded the President’s Award for Outstanding Nursing by President Kennedy in 1962 and she was inducted into the Montana Hall of Fame in 1987. In 2002, she was also inducted into the American Nurses Association Hall of Fame.

While Susie Walking Bear Yellowtails’ career and advocacy efforts positively impacted the Crow people and other Native American tribes in her lifetime, her work served as an example on how health rights activists could monitor and document patient mistreatment by the medical field. Yellowtail used her Crow identity and nursing education to provide culturally sensitive care to the Native Americans who requested her services. As one of the first registered nurses of Native American descent, Susie Yellowtail embedded herself in the medical field and brought about long-lasting changes that can still be felt to this day.

Sources

“Susie Walking Bear Yellowtail: ‘Our Bright Morning Star.’” Women’s History Matters, 6 May 2014, montanawomenshistory.org/susie-walking-bear-yellowtail-our-bright-morning-star.

Theobald, Brianna. “Nurse, Mother, Midwife-Susie Walking Bear Yellowtail and the Struggle for Crow Women’s Reproductive Autonomy.” Montana The Magazine of Western History, vol. 66, no. 3, 2016. National Indigenous Women’s Resource Center, www.niwrc.org/resources/journal-article/nurse-mother-midwife-susie-walking-bear-yellowtail-and-struggle-crow.

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