Indian Health Service

Indian Health Service. In 1873, amid growing national interest in social and public‐health reforms, the Office of Indian Affairs in the Department of the Interior created a Medical and Educational Division, forerunner of today's extensive, multitasked Indian Health Service. At the time, only about half of the nation's seventy‐four reservations employed physicians. Despite the subsequent construction of the first Indian hospitals, more rigorous hiring standards for medical personnel, and a late‐1880s policy shift toward disease prevention, rampant epidemic disease and malnutrition persisted.

Throughout the nineteenth century, health care competed poorly with educational efforts for the Interior Department's meager resources. In the period 1900–1920, however, a number of bureaucratic changes and budgetary successes enhanced Indian health services. In 1908, the department created the position of chief medical supervisor to oversee the medical service. In 1911, the first congressional appropriation specifically for general health services to Indians resulted in the addition of dentists and public‐health nurses.

A reorganization of the Indian Bureau in 1924 resulted in a separate Medical Division (in 1931 renamed the Health Division, later the Indian Health Service). In 1926, the medical division itself reorganized, expanded, and added supervisors detailed from the U.S. Public Health Service. The pre–World War II period brought expansion for the medical department. Its staff successfully treated trachoma, conducted sanitation surveys, and built more hospitals. Service hospitals were now the site of 80 percent of Indian births, reflecting the degree of native trust.

Yet federal studies of reservations, such as the 1928 Meriam Report, consistently found abysmal health conditions. Controversies over salaries and limited resources persisted as well. Reformers and the National Tuberculosis Association called for transfer of medical services from the Interior Department to the Public Health Service, and in 1955 Public Law 568 did just that: The Indian Health Service became part of the new Department of Health, Education, and Welfare (now the Department of Health and Human Services). In subsequent years, personnel, budgets, facility construction, and the numbers of patients served increased dramatically. Troubling discrepancies persisted, however, between health statistics for the 1.5 million Native Americans and those of the general population.
See also Bureau of Indian Affairs; Federal Government, Executive Branch: Other Departments (Department of Health and Human Services); Health and Fitness; Indian History and Culture: 1800 to 1900; Indian History and Culture: From 1900 to 1950; Since 1950: Indian History and Culture; Since Medicine: From the 1870s to 1945; Medicine: Since 1945; Public Health; Tuberculosis.

Bibliography

Todd Benson , Race, Health, and Power: The Federal Government and American Indian Health, 1909–1955, Ph.D. diss., Stanford University, 1994.
Robert A. Trannert , White Man's Medicine: Government Doctors and the Navajo, 1863–1955, 1998.

Diane D. Edwards