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Document Type

Research Paper

Abstract

Service in 1955 represented a significant shift in federal policy aimed at addressing the substandard health conditions of American Indians and Alaska natives. For over a century, the Bureau of Indian Affairs managed these services, but by the mid-twentieth century, the Indian population faced mortality rates for preventable diseases, such as measles and pneumonia, that were many times higher than those of the white population. Proponents of the transfer, including various medical associations and state governors, argued that the Public Health Service possessed the professional resources, clinical expertise, and career incentives necessary to recruit qualified personnel and provide modern preventive care. Despite some opposition concerning the loss of tribal hospitals and the complexity of existing treaty obligations, Public Law 568 was enacted in 1954 to effectuate the change. 

Upon assuming responsibility, the Public Health Service established the Division of Indian Health and conducted extensive surveys to identify the most pressing needs. These studies revealed a massive backlog of neglect, characterized by outmoded hospital facilities, primitive sanitation, and a severe lack of staff housing in isolated areas. The new administration focused on expanding field health services, increasing the number of physicians and dentists, and implementing sanitation projects to provide safe water and waste disposal. While the program faced obstacles such as geographical isolation and cultural differences, early results indicated a measurable increase in patient care and tribal cooperation. Ultimately, the transfer was viewed as an evolutionary process to improve the physical and psychological well-being of Indian communities, thereby facilitating their eventual integration into modern society.

Research Highlights

  • The Problem: Deplorable health conditions among American Indians and Alaska natives, characterized by a lack of understanding and accumulated neglect that resulted in a massive backlog of disease, ill health, and disability. 

  • The Method: A multi-faceted evaluation involving an analysis of birth and death statistics from nine selected reservations, house-to-house family surveys, medical studies of population samples, and questionnaires sent to State and local health departments. 

  • Quantitative Finding: Indian infant death rates reached 76 per 1,000 live births compared to 28 per 1,000 in the general U.S. population; the 1953 death rate for Indian children was more than double the national average; and the total Indian population in 1955 was approximately 472,000 in the continental United States. 

  • Qualitative Finding: Major obstacles to health improvement included the geographic isolation of 250 differing tribes, significant language and cultural barriers, and the resistance of some Indian groups to using general community services. 

  • Finding: The 1955 transfer of health responsibility to the Public Health Service aimed to improve staffing and professional supervision, though it faced initial opposition due to fears of hospital liquidation and the potential ill psychological effects on Indian communities. 

Publication Date

1-1958

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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