Printer-friendly Version

Page 1 of 5

Integrating American Indians and Alaska Natives into the Body Politic

A snowplow diesel train chugged southwest through a brisk night in December 1955. The engine trailed an old-fashioned boxcar, one door ajar, letting in the crisp air outdoors. Inside, huddled in blankets and perched about a potbelly stove, Margaret West, Ruth Raup, and Burnet Davis of the Public Health Service (PHS) contemplated the enormous task before them.

The previous year, under the provisions of PL (Public Law) 83-568, Congress had moved the Bureau of Indian Affairs (BIA) Indian Service, Health Division from the Department of the Interior to PHS. The transfer was part of the Eisenhower Administration's version of Federal "termination" policies intended to assimilate indigenous people into "Anglo" society by terminating Federal obligations originally established by treaty. With the transfer, PHS embarked on a temporary crash program to improve the health status of the 315,000 American Indians and 35,000 Alaska Natives (Indian, Aleut, and Inuit formerly under BltVs care. PHS inherited the Health Division's 3500 employees stationed mostly at remote locations west of the Mississippi River, and $40 million worth of real estate in 23 states and the Alaskan Territory. Congress also gave Surgeon General Leonard Scheele $250,000 to survey PHS's new holdings and submit a detailed request for appropriations. It was this survey that our trio of PHS researchers had been dispatched to conduct.

Between October 1955 and June 1956, West, Raup, and Davis interviewed reservation residents, inspected Indian hospitals, and observed maternal and child health clinics at reservations in Montana (Crow), South Dakota (Yankton), Nebraska (Acoma Pueblo). Arizona (San Carlos), Oregon (Warm Springs), Washington (Colville), Wisconsin (Lac Courte Oreilles), Minnesota (White Earth), and Idaho (Fort Hall). The threesome reported desperate circumstances and ill health, observations that echoed former Surgeon General Thomas Parran's findings during a 1953 survey of Alaskan villages.

The pairing of investigators from different branches of PHS West and Raup were from the Division of Public Health Methods and Davis was head of the Bureau of Medical Services reflected a key tension animating policy debate. Division of Public Health Methods researchers brought to their quantitative studies a New Deal commitment to social justice and a belief that the Federal government was obliged to uphold this commitment. Bureau of Medical Services staff were more pragmatic. Their Bureau was pinched between new demands made by groups of beneficiaries added during World War II and postwar efforts by Congress and the Bureau of the Budget to divest PHS of the health care business entirely.

continue