The public health foundation of health services for American Indians & Alaska Natives.
The integration of public health practices with federal health care for American Indians and Alaska Natives (AI/ANs) largely derives from three major factors: the sovereign nature of AI/AN tribes, the sociocultural characteristics exhibited by the tribes, and that AI/ANs are distinct populations residing in defined geographic areas. The earliest services consisted of smallpox vaccination to a few AI/AN groups, a purely public health endeavor. Later, emphasis on public health was codified in the Snyder Act of 1921, which provided for, among other things, conservation of the health of AI/AN persons. Attention to the community was greatly expanded with the 1955 transfer of the Indian Health Service from the US Department of the Interior to the Public Health Service and has continued with the assumption of program operations by many tribes themselves. We trace developments in integration of community and public health practices in the provision of federal health care services for AI/AN persons and discuss recent trends.
Everett R. Rhoades is with the Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City. Dorothy A. Rhoades is with the Division of General Internal Medicine, Department of Medicine, and the Stephenson Cancer Center, University of Oklahoma Health Sciences Center.
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D000413:Alaska; D003466:Cultural Characteristics; D006291:Health Policy / Q000266:history*; D006297:Health Services Accessibility / Q000266:history; D006303:Health Services, Indigenous / Q000266:history*; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D015980:Public Health Practice / Q000266:history*; D014481:United States; D016549:United States Indian Health Service / Q000266:history*