Article

The Indian Health Service and the Sterilization of Native American Women

Authors:
If you want to read the PDF, try requesting it from the authors.

Abstract

The American Indian Quarterly 24.3 (2000) 400-419 A young Indian woman entered Dr. Connie Pinkerton-Uri's Los Angeles office on a November day in 1972. The twenty-six-year-old woman asked Dr. Pinkerton-Uri for a "womb transplant" because she and her husband wished to start a family. An Indian Health Service (IHS) physician had given the woman a complete hysterectomy when she was having problems with alcoholism six years earlier. Dr. Pinkerton-Uri had to tell the young woman that there was no such thing as a "womb transplant" despite the IHS physician having told her that the surgery was reversible. The woman left Dr. Pinkerton-Uri's office in tears. Two young women entered an IHS hospital in Montana to undergo appendectomies and received tubal ligations, a form of sterilization, as an added benefit. Bertha Medicine Bull, a member of the Northern Cheyenne tribe, related how the "two girls had been sterilized at age fifteen before they had any children. Both were having appendectomies when the doctors sterilized them without their knowledge or consent." Their parents were not informed either. Two fifteen-year-old girls would never be able to have children of their own. What happened to these three females was a common occurrence during the 1960s and 1970s. Native Americans accused the Indian Health Service of sterilizing at least 25 percent of Native American women who were between the ages of fifteen and forty-four during the 1970s. The allegations included: failure to provide women with necessary information regarding sterilization; use of coercion to get signatures on the consent forms; improper consent forms; and lack of an appropriate waiting period (at least seventy-two hours) between the signing of a consent form and the surgical procedure. This paper investigates the historical relationship between the IHS and Indian tribes; the right of the United States government to sterilize women; the government regulations pertaining to sterilization; the efforts of the IHS to sterilize American Indian women; physicians' reasons for sterilizing American Indian women; and the consequences the sterilizations had on the lives of a few of those women and their families. The IHS evolved out of various government programs designed to address the health care issues of American Indians. Under the auspices of the War Department in the early 1800s, "Army physicians took steps to curb smallpox and other contagious diseases of Indian Tribes living in the vicinity of military posts." Army physicians used vaccinations and other medical procedures to prevent both military men and the Indians they came in contact with from being infected with diseases. The first treaty that included medical services was signed between the United States and the Winnebago Indians in 1832. In 1832 Congress provided funding for Indian health care in the amount of twelve thousand dollars. In 1849 Congress transferred the Bureau of Indian Affairs (BIA) from the War Department to the Department of the Interior, including all health care responsibilities for American Indians. By 1875 half of the federal Indian agencies had physicians, and the BIA built the first federal hospital for Indians in Oklahoma during the late 1880s. After the turn of the century, the BIA created a separate health division and appointed district medical directors. The health division started special programs to combat tuberculosis and other diseases and established health education classes to support these programs. The Snyder Act of 1921 included congressional authorization for the BIA to provide Indian health care "for the benefit, care, and assistance of the Indians throughout the United States." The BIA contracted with the Public Health Service (PHS) in 1928 to provide sanitation engineers to investigate water and sewage problems at BIA facilities and renewed and expanded that contract through the early 1950s. In 1955 Congress transferred total responsibility for Indian health from the Department of the Interior to the Public Health Service. The legislation stated that "all facilities transferred shall be available to meet the health needs of the Indians and that such health needs shall be given priority over that of the non-Indian population." The PHS, a division of the Department of Health, Education, and Welfare (HEW), formed the Division of Indian Health, which was renamed...

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the author.

... Although female sterilization can be an empowering method of contraception, it has negative history as a method used to eugenically control and marginalize minority populations, including Native American women [22]. The U.S. government agency personnel targeted Native Americans for family planning because of their high birth rate [23]. In 1955, Congress transferred total responsibility for Native health from the Department of Interior (formerly the Department of War) to the Public Health Service (PHS). ...
... The legislation stated that, "All facilities transferred shall be available to meet the health needs of the Indians and that such health need shall be given priority over that of the non-Indian population." The PHS, a division of the Department of Health, Education, and Welfare (HEW), formed the Division of Indian Health, which was renamed the Indian Health Service (IHS) in 1958 [23]. The IHS began providing family planning services for Native Americans in 1965 under the authority of HEW and PHS. ...
... The 1970 census revealed that the average Native woman bore 3.79 children, whereas the median for all groups in the U.S. was 1.79 children [23]. Protests and investigations that emerged in 1970s showed that the public health system, primarily the IHS, was sterilizing Native American women without their knowledge or informed consent [24]. ...
Article
Full-text available
Despite a global and nationwide decrease, Native Americans continue to experience high rates of cancer morbidity and mortality. Vaccination is one approach to decrease cancer incidence such as the case of cervical cancer. However, the availability of vaccines does not guarantee uptake, as evident in the Coronavirus 2019 pandemic. Therefore, as we consider current and future cancer vaccines, there are certain considerations to be mindful of to increase uptake among Native Americans such as the incidence of disease, social determinants of health, vaccine hesitancy, and historical exclusion in clinical trials. This paper primarily focuses on human papillomavirus (HPV) and potential vaccines for Native Americans. However, we also aim to inform researchers on factors that influence Native American choices surrounding vaccination and interventions including cancer therapies. We begin by providing an overview of the historical distrust and trauma Native Americans experience, both past and present. In addition, we offer guidance and considerations when engaging with sovereign Tribal Nations in vaccine development and clinical trials in order to increase trust and encourage vaccine uptake.
... Reproductive justice-frequently defined as including the right to have children, to not have children, and to parent children in safe and healthy environments-is an important social justice issue for women of color, who have experienced extensive reproductive oppression both historically and contemporarily (SisterSong, 2006). This topic has also received attention for Indigenous women, with particular focus on the high rates of sterilization experienced by women on many reservations (Gurr, 2014;Lawrence, 2000;Theobald, 2019). However, other factors which act as barriers for women achieving their reproductive goals, such as high rates of endometriosis and inability to pay for fertility treatments, have been less frequently explored through the lens of reproductive justice. ...
... However, other factors which act as barriers for women achieving their reproductive goals, such as high rates of endometriosis and inability to pay for fertility treatments, have been less frequently explored through the lens of reproductive justice. In addition, these topics have not been explored for women who are members of nonfederally recognized tribes, and who do not receive healthcare from a centralized system, such as the Indian Health Service (IHS) (Krieger & Fee, 1994;Lawrence, 2000;Gurr, 2014;Theobald, 2019;Torpy, 2000). ...
... Although the contraceptive experiences of Indigenous women tend to primarily be discussed in relation to high rates of hysterectomy and sterilization (Cackler et al., 2016;Gurr, 2014;Kluchin, 2011;Lawrence, 2000;Theobald, 2019), scholars have also noted that women of color are more likely to live in "contraceptive deserts" (Kreitzer et al., 2020). National level data about the contraceptive methods used by Indigenous women are incomplete and are non-existent for state-recognized tribes in the southeastern United States; however, findings from the 2002 National Survey for Family Growth indicate that 61% of Indigenous women ages 18 to 44 were not using any form of contraception (Rutman et al., 2012). ...
Article
Reproductive justice is increasingly being utilized as a framework for exploring women’s reproductive health experiences. However, this topic has not yet been explored among Indigenous state-recognized tribes who do not utilize the Indian Health Service, and little research explores what other factors impact women's ability to reach their reproductive goals. A qualitative descriptive research methodology was used to explore experiences of reproductive justice among members of an Indigenous state-recognized tribe in the Gulf Coast. Data were collected through qualitative semi-structured life-history interviews with female tribal members. Several key themes emerged illustrating barriers related to women achieving their reproductive desires. These included: (a) High Prevalence of Hysterectomy or Sterilization; (b) Experiences with Infertility Common; and (c) High Frequency of Polycystic Ovary Syndrome or Endometriosis. Findings of this study reveal that Indigenous women face multiple barriers to achieving reproductive justice. This study is unique in exploring the family planning desires and goals, and the barriers experienced in achieving these reproductive desires, for women in a Gulf Coast, non-federally recognized Indigenous tribe. These results contextualize national trends and suggest that Indigenous women in this study experience reproductive injustices that harm their ability to achieve their reproductive desires.
... Rebecca M. Kluchin's enquiry into neo-eugenic policies during the 1960s and 1970s finds that, in the USA, women of colour 'struggled to resist coercive sterilization' (Kluchin 2011, 8). Guided by the assumption that restricting birth rates on Native reservations would reduce dependence on government assistance, IHS physicians and other services, contracted by the IHS, sterilised between 25% and 42% of Native American women of childbearing age during the 1970s (Kluchin 2011, 7;Lawrence 2000). Several factors call into question the voluntariness of these procedures and instead point to widespread practices of sterilisation abuse. ...
... The 1976 Indian Healthcare Improvement Act saw greater Native participation within and control over IHS facilities. This, together with regulations introduced in 1979 by the Department of Health, Education and Welfare designed to prevent coercive sterilisations, did bring about a reduction in sterilisation abuse (Lawrence 2000). More difficult to eradicate, however, are the 'attitudes that perpetuate the subjugation of women's bodies' (Vicenti Carpio 2004, 51). ...
Article
Full-text available
This article argues that the health humanities must examine biocolonialism (and representations thereof) if it is to attend to Native American experiences of reproductive healthcare in the USA. Reproductive healthcare abuses are brought into dialogue with Native American resistance to Western biomedical sciences in Future Home of the Living God (2017) by Louise Erdrich (Ojibwe). Written over the course of two reinstatements of the Mexico City Policy, Erdrich’s novel invites a consideration of biocolonialism in relation to the exploitation and policing of female bodies. After a discussion of bioprospecting and female bodies, I frame unethical practices of reproductive healthcare and sterilisation as biocolonial acts. The experience of the novel’s protagonist, Cedar Hawk Songmaker, will be situated alongside the broader ways in which Native Americans are subjected to surveillance. Second, this article proposes that speculative fiction allows for a temporal reframing of the colonial histories of Indigenous healthcare. As she narrates a world in which evolution ‘is running backward’, Cedar employs narrative reversals to resist the linear narrative of progress and ‘discovery’ associated with biomedical sciences. The radically changing structures of a dystopian state, as well as the revelation of her biological inheritance, complicate the cultural and medical frameworks within which Cedar narrates her pregnancy. A challenge faced by the health humanities is how the discipline might theorise ongoing, interrelated forms of domination such as those which position female Indigenous bodies as ‘new colonies’. But, as I will argue, the mobilisation of Indigenous narrative forms and cultural frameworks offer productive directions for future work within the global health humanities.
... 52 More than 30% of Puerto Rican women were sterilized in the 1960s to 1970s, with many such procedures done under coercive conditions. 53,54 In addition to the 1830 Indian Removal Act's associated suffering and death, Indigenous women have been subjected to negative assumptions about their behaviors (e.g., "savage and hypersexual nature"), inadequate reproductive health care, and mass sterilization in a manner akin to eugenics. 46,55 In 1849, the Department of the Interior took responsibility for the health of Indigenous people to prevent infectious disease transmission to military bases. ...
... 55 Investigations into the reports of the Indian Health Service reveal that about one-quarter of Indigenous women were sterilized in the 1970s without their consent. 54 Earned Mistrust of Behavioral or Psychiatric Health Care Mental health care systems, both in general and regarding psychiatry in particular, have earned skepticism and mistrust apart from the consideration of specific harms inflicted on minoritized individuals. Media portrayals of certain stereotypes in diagnosis and management and of individuals living with behavioral health disorders have attained iconic or even caricature status in the minds of many Americans. ...
Article
Despite the advancement of telemedicine and recent innovations in treatment, minoritized women continue to bear a disproportionate burden of pregnancy-related psychiatric conditions and complications, which the pandemic has further exacerbated. Research demonstrates that medical mistrust and systemic racism play central roles in the underutilization of services by racially and ethnically diverse women during pregnancy and postpartum. To effectively address these disparities, it is imperative to understand the drivers of medical mistrust in perinatal health care systems. This Perspectives article describes the historical context of medical mistrust in psychiatric and obstetric health systems and offers solutions to mitigate mistrust and the impact of systemic racism on perinatal care.
... Government Accountability Office, 1976) . It should be noted that this investigation examined only four of the 12 IHS hospitals, so the actual number of sterilizations is probably substantially higher (Lawrence, 2000) . This investigation concluded that consent forms for sterilization procedures were not in compliance with regulations because they did not present the basic elements orally, contain written summaries of the oral presentation, or contain a statement indicating a right to withdraw on the top of the page (U . ...
... Social workers working with Indigenous children and families pressured women to undergo medical procedures to keep their welfare benefits (Kennedy, 2008;Lawrence, 2000;Petchesky, 1990, Torpy, 2000University of Vermont, 2011) . An Indigenous woman recalls social workers coming to her home in 1973 and claims, "They told me that I should be sterilized because I didn't want any more babies right then, so I said yes and signed a consent form . My tubes were tied the next day" (Lawrence, 2000, p . ...
... These challenges may be compounded by a lack of healthcare and insurance services that are congruent with the knowledge systems and informational needs of this population, which may include low health literacy (i.e., the ability to locate, understand, and use information about health and healthcare) caused by a lack of educational opportunity (18), difficulty using the technology involved in finding health information (19,20), and problems with information processing caused by impairments in cognition, vision, or hearing (21). Finally, Elders may be deterred from seeking care by experiences of discrimination, poor treatment, and cultural memories of medical atrocities, such as the forced sterilization of American Indian women (22)(23)(24)(25). This study examines Elders' challenges in establishing a reliable relationship with a healthcare provider in this context and the potential consequences of lacking one. ...
... In addition to these challenges, this analysis also underscores the role of fear, mistrust, and negative associations related to healthcare. Indeed, many American Indian Elders' decisions about healthcare are influenced by personal or collective memories of discrimination, neglect, and abuse at the hands of the U.S. healthcare system, such as the sterilization of American Indian women (23) and unethical medical testing with American Indian children (41). Indeed, medical mistrust and experiences of discrimination and microaggressions are strongly associated with poor healthcare outcomes among American Indians (25,(42)(43)(44). ...
Article
Full-text available
Having a regular relationship with a healthcare provider contributes to better health outcomes and greater satisfaction with care for older adults. Although members of federally recognized American Indian tribes have a legal right to healthcare, American Indian Elders experience inequities in healthcare access that may compromise their ability to establish a relationship with a healthcare provider. This multi-year, community-driven, mixed-method study examines the potential causes and consequences of not having a personal healthcare provider among American Indian Elders. Quantitative surveys and qualitative interviews were conducted with 96 American Indian Elders (age 55 and over) in two states in the Southwestern United States. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. Findings confirmed that having a consistent healthcare provider correlated significantly with self-rated measures of health, confidence in getting needed care, access to overall healthcare, and satisfaction with care. Lack of a regular healthcare provider was related to interconnected experiences of self-reliance, bureaucratic and contextual barriers to care, and sentiments of fear and mistrust based in previous interactions with medical care. Increasing health equity for American Indian Elders will thus require tailored outreach and system change efforts to increase continuity of care and provider longevity within health systems and build Elders' trust and confidence in healthcare providers.
... In this way, scientific ideas that biologically essentialize race have served the interests of white supremacist systems and structures by providing seemingly objective legitimation for racial hegemony (Roberts, 2017(Roberts, , 2018Desmond and Emirbayer, 2009;Omi and Winant, 2014;Williams, 2016). Operating within these systems, the pseudo-scientific assertions of medical practitioners functioned to justify atrocities and injustices ranging from slavery (Washington, 2008), to lynching (Stein, 2015), to racist and xenophobic immigration restriction policies (Molina, 2006;Young, 2017), to eugenic forced sterilization practices (Lawrence, 2000;Roberts, 2017;Stern, 2005;Washington, 2008), to residential segregation (Molina, 2006). Scientific racism has "explained domination of one group over another as the natural order of things" (Roberts, 2017), at times implicating medical science itself as a "racial project" (see Omi and Winant, 2014). ...
Article
This paper presents a critique of clinical practice guidelines (CPGs) that standardize the use of race as a proxy for biological difference in medical settings. Drawing on the illustrative example of a pediatric UTI testing guideline, we contend that when CPGs necessitate that Black patients meet a higher threshold of illness severity or duration than their non-Black counterparts to receive comparable medical testing or other medical care, they function as mesolevel sites of race-racism reification processes (see Sewell 2016) that contribute to the reproduction of racial health disparities. We describe broader implications and make recommendations for the conceptualization and implementation of future research in the sociological study of race, health, and medicine.
... The call for greater inclusion of BIPOC in male reproductive health studies comes while also acknowledging the long history of exploitation of these communities in medical research. The U.S. Public Health Service's 40 year Tuskegee Syphilis Study conducted on Black American sharecroppers and the Indian Health Service's efforts in the 1960s and 70s to sterilize Native Americans are two historical examples in a long legacy of egregious research misconduct [77,78]. Mistrust of clinical research among marginalized communities of color is well-documented, manifesting as beliefs that it may be conducted without knowledge or consent, on unwilling participants, or that it may increase risk of harm from medical treatments and procedures [79][80][81][82]. ...
Article
Full-text available
Background Epistemological biases in environmental epidemiology prevent the full understanding of how racism’s societal impacts directly influence health outcomes. With the ability to focus on “place” and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. Objective This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. Discussion While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology’s dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing “race”, conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.
... Eugenics, racism, and laws encouraging the sterilization of "socially inadequate persons," "promiscuous" women, the "feeble-minded," habitual criminals, and others were a part of governmental programs to maintain the demographic advantage of "the race" (Ross and Sollinger 2017). Non-consensual sterilizations carried out on Native American women and girls by the United States Indian Health Service continued well into the late twentieth century (Lawrence 2000). The pseudoscience of eugenics and social Darwinism continued to justify the experimental exploitation and shoddy medical treatment of Black people and people of color, due to the view that they were biologically inferior, oversexed, and unfit for adult responsibilities (Washington 2006). ...
Article
This thematic volume explores how health, well-being, and ability are constructed in the past and in the present. The volume’s authors undo and question deeply ingrained assumptions about what constitutes a “normative” body. They do so by not only looking at how bodies have been medicalized and envisioned in the past, but also how our own profession and discipline discriminates against certain types of bodies in the present.
... Ultimately, the decision of when to start and stop reparations must be iterative, with ongoing considerations and reviews. Finally, we want to re-emphasize that while this piece focused on reparative policies for Black Americans based on the medical profession's history of racism, there are other historically marginalized populations, such as the Native American and other communities of color, that have suffered unmeasurable historical injustice, including specifically at the hands of physicians (52), and they must also be the beneficiaries of similar, necessary reparative policies. ...
Article
Full-text available
The disproportionate impact of COVID-19 on racially marginalized communities has again raised the issue of what justice in healthcare looks like. Indeed, it is impossible to analyze the meaning of the word justice in the medical context without first discussing the central role of racism in the American scientific and healthcare systems. In summary, we argue that physicians and scientists were the architects and imagination of the racial taxonomy and oppressive machinations upon which this country was founded. This oppressive racial taxonomy reinforced and outlined the myth of biological superiority, which laid the foundation for the political, economic, and systemic power of Whiteness. Therefore, in order to achieve universal racial justice, the nation must first address science and medicine's historical role in scaffolding the structure of racism we bear witness of today. To achieve this objective, one of the first steps, we believe, is for there to be health reparations. More specifically, health reparations should be a central part of establishing racial justice in the United States and not relegated to a secondary status. While other scholars have focused on ways to alleviate healthcare inequities, few have addressed the need for health reparations and the forms they might take. This piece offers the ethical grounds for health reparations and various justice-focused solutions.
... Internationaly, researchers advocate that family and community involvement is relevant for social work in indigenous communities (Belone et al., 2002;Drywater-Whitekiller, 2014;Gray et al., 2007;Henriksen, 2004;Herzberg, 2013;O'Neill & Gonzalez, 2014;Stewart, 2008). Throughout history, social work has contributed to the colonization and oppression of indigenous people, by removing children from their families (Godinet et al., 2010;Jones, 1995;Shamini et al., 2015;Sullivan & Walters, 2011), lack of culturally informed services (Herring et al., 2013;Lawler et al., 2012), and colonial structures undermining indigenous peoples access to and control over their social and physical health (de Leeuw et al., 2010;Lawrence, 2000). Worldwide, indigenous communities and researchers are searching for new ways of organizing social work to make it more culturally appropriate (Bennett et al., 2011;Gray et al., 2013;Herring et al., 2013;J€ arvensivu et al., 2016). ...
Article
Full-text available
This study investigates family involvement and culturally informed social work in Native American communities. The study was conducted in Native American communities in Montana, USA. Twenty-three Native American social work professionals participated in qualitative interviews. Analyses draw on theory of historical trauma and family involvement in indigenous social. Throughout the study, indigenous methodology has been a central principle. Findings Among social workers, there is a common understanding that social work should involve family and community if it is to be culturally informed. Social work professionals talk of family involvement in indigenous social work as “common sense.” For the Native American social work professionals interviewed, the following tenets are all “common sense”: (1) family and community belonging are important aspects of Native American culture; 2) oppression and colonization had a negative impact on family, community, and tribal relations; and (3) social work has an obligation to restore family, community, and tribal relations. Application Social work has a responsibility to connect culture, trauma, and the resolution of trauma. Furthermore, family and community involvement plays a core part in restoration and resilience processes, healing historical trauma caused by the colonization. Hence, in order to provide culturally competent care, social work practices serving Native American clients should involve family and community. Mainstream social work does not sufficiently build on family involvement as an ideological foundation for qualitatively good social work. We argue that social work curricula impacting Native clients could benefit from the experience and knowledge of these Native American social workers.
... She notes that providing the social supports necessary for women's individual decisions to be optimally realized includes government obligations to protect women's human rights and ensure that options for making choices are safe, affordable, and accessible. In the past 30 years alone, American Indian women's ability to conceive and raise children has been impacted by forced sterilization in Indian Health Services facilities (Lawrence 2000), and rampant adoption out of American Indian children into non-Indian homes (O'Sullivan 2016), following on centuries of outright genocide and forced attendance in boarding schools. ...
... An extreme version of those concerns about experience-based mistrust are the historic betrayals of various ethnic and racial groups, such as experiments to eliminate trachoma and forced sterilizations in native Americans (Canales et al. (2011), Benson (1999; Lawrence (2000)) Similarly, the Tuskegee experiment has been linked to Black Americans mistrusting doctors to save their lives if they are an organ donor (Siminoff et al. (2006)). ...
Article
Personal experiences of economic outcomes, from global financial crises to individual-level job losses, can shape individual beliefs, risk attitudes, and choices for years to come. A growing literature on experience effects shows that individuals act as if past outcomes that they experienced were overly likely to occur again, even if they are fully informed about the actual likelihood. This reaction to past experiences is long-lasting though it decays over time as individuals accumulate new experiences. Modern brain science helps understand these processes. Evidence on neural plasticity reveals that personal experiences and learning alter the strength of neural connections and fine-tune the brain structure to those past experiences (“use-dependent brain”). I show that experience effects help understand belief formation and decision-making in a wide range of economic applications, including inflation, home purchases, mortgage choices, and consumption expenditures. I argue that experience-based learning is broadly applicable to economic decision-making and discuss topics for future research in education, health, race, and gender economics.
... They also fit within a historical context of discrimination, abuse, and neglect against AIs within the U.S. health care system that has not been redressed. Individual and cultural memories of atrocities, such as the forced sterilization of AI women well into the latter half of the 20 th century (Lawrence, 2000), as well as everyday experiences of stigma and mistreatment at the hands of medical providers, shape Elders' trust in, and engagement with, the health care system (Armenta et al., 2021;Guadagnolo et al., 2009;Simonds et al., 2014). As we argue elsewhere (Sommerfeld et al., 2021;Willging et al., 2021), our findings illuminate an urgent need to prioritize system and organizational changes to facilitate Elders' use of health care, including advocating for state and federal governments to meet their treaty obligations by securing stable and adequate funding for tribal health care facilities to provide a full range of care and devoting more resources to helping Elders navigate the health care system. ...
Article
Full-text available
Inequities in access to health care create barriers to physical and mental health treatment for the rapidly aging American Indian population in the United States. This study uses concept mapping-a participatory, mixed-methods approach to understanding complex phenomena-to examine the perceived impacts of multilevel factors influencing Elders' ability to access and use health care and how these perceptions vary according to gender and age, with the aim of identifying tailored strategies to address inequities. Using data from a purposive sample of American Indian Elders (n = 65) in two states, we compared ratings of thematic clusters and individual factors perceived to impact Elder health care across four participant subgroups: women aged 55-64, women aged 65+, men aged 55-64, and men aged 65+. Provider Issues and Relationships and Tribal/National Policy were themes perceived to have a particularly high impact on Elder health. Key variations between subgroups regarding individual health care access factors reflected unique interpersonal and accessibility challenges among older women, problems stemming from lack of familiarity with health care among younger Elders and men, and challenges navigating complex bureaucracies and tribal decision-making processes among older Elders. Findings underscore the need to address multilevel gender- and age-specific factors contributing to health disparities for Elders.
... Power and authority held by many Indigenous women in their Native communities also posed a direct threat to the patriarchal colonial system, so that violence against women served as a tool of colonization (Bagwell-Gray et al., 2021;Smith, 2015). In line with the settler colonial "logic of elimination," Smith (2003, p. 79) argues that "Native women are also threatening because of their ability to reproduce the next generation of peoples who can resist colonization," which led to further tactics of bodily control including the sterilization of Indigenous women and other forms of sanctioning Indigenous sexuality (Lawrence, 2000;Simpson, 2017). ...
Article
Full-text available
Indigenous women in the United States experience disproportionately higher rates of intimate partner violence (IPV) compared to their non‐Indigenous counterparts. Through a framework of settler colonialism, this article examines how settler colonial gender practices disrupted and eroded generational patterns of gender roles and power relationships within Indigenous communities, contributing over time to today's higher levels of IPV perpetrated against Indigenous women. I argue that future research on IPV must attend to the historical, contemporary, and legal impacts of settler colonial policies and laws that contribute to increased rates of violence within marginalized and racialized communities. In this article, I first review dominant theories of IPV, then review how a theoretical framework of settler colonialism expands our understanding of IPV in Indigenous communities, and, finally, address the impacts of federal policies on Indigenous sovereign rights regarding violence against women.
... The United States has a history of sterilizing so-called "undesirable" populations. At one time or another, people who have been forcibly sterilized include those held in psychiatric institutions, immigrants, low-income women of color, Native American women, and incarcerated people (Lawrence, 2000;Roberts, 1997;Stern, 2005). Forced sterilization as punishment for criminal offenses should have been halted with the U.S. Supreme Court's ruling in Skinner v. Oklahoma (1942), but the practice persists in different forms. ...
Article
Full-text available
This article provides an introduction to sex‐positive criminology and its goals for change. Sex‐positive criminology draws from the “thick desire” organizing principle, which is a rights‐based approach to human sexuality, as well as from positive sexuality approaches. It also draws from critical, queer, and feminist criminological traditions and abolitionist sensibilities. We discuss examples that pertain to key tenets of sex‐positivity: consent and bodily autonomy, education, medical access, harm reduction, and ways to increase agency. Main topics of discussion include addressing deeply harmful and sex‐negative laws and policies that perpetuate state violence, such as coerced or forced sterilization, criminalization of abortion and pregnancy loss, sexual and physical assault of sex workers by police, criminalization through medically inaccurate laws, and legislation such as Allow States and Victims to Fight Online Sex Trafficking Act and the Stop Enabling Sex Traffickers Act that puts marginalized populations at risk. Throughout, we reflect on possibilities for sex‐positive laws and policies and the social impacts they would have, such as improving health and well‐being.
... [6] It also includes a history of forced sterilization practices exerted on women in Indigenous communities without informed consent at the hands of Indian Health Services (IHS) physicians. [7] Furthermore, American Indian/Alaska Native communities are familiar with the devastating impacts of infectious diseases on their communities, having experienced significant population reduction after introduction of diseases like smallpox, measles, and influenza by European colonizers. [8] According to Desi Rodriguez-Lonebear, a social demographer at the University of Arizona and citizen of the Northern Cheyenne tribe in Montana, "More than any other population in the country, the shared experience of surviving a pandemic is in our blood, it's not historic, it's current for American Indians, it's our reality. ...
Article
Full-text available
During the COVID-19 pandemic, we have witnessed profound health inequities suffered by Black, Indigenous, and People of Color (BIPOC). These manifested as differential access to testing early in the pandemic, rates of severe disease and death 2-3 times higher than White Americans, and now, significantly lower vaccine uptake compared with their share of the population affected by COVID-19. This article explores the impact of these COVID-19 inequities (and the underlying cause, structural racism) on vaccine acceptance in BIPOC populations, ways to establish trustworthiness of healthcare institutions, increase vaccine access for BIPOC communities, and inspire confidence in COVID-19 vaccines.
... Consequently, the care provided by the IHS has been neglectful, harmful, and inadequate (Dillingham 1977;Lawrence 2000;Roubideaux 2002). Today, one of the consequences of these structural features of federal Indian policy neglect is that 25% of American Indians and Alaska Natives die before the age of 45, compared to 8% of the rest of the U.S. population (Indian Health Service 2014). ...
Article
We draw on new and original data to examine both partisan and systemic inequities that have fueled the spread of COVID-19 in Native America. We show how continued political marginalization of Native Americans has compounded longstanding inequalities and endangered the lives of Native peoples. Native nations have experienced disproportionate effects from prior health epidemics and pandemics, and in 2020, Native communities have seen greater rates of infection, hospitalization, and death from COVID-19. We find that Native nations have more COVID-19 cases if they are located in states with a higher ratio of Trump supporters and reside in states with Republican governors. Where there is longstanding marginalization, measured by lack of clean water on tribal lands and health information in Native languages, we find more COVID-19 cases. Federal law enables non-members to flout tribal health regulations while on tribal lands, and correspondingly, we find that COVID-19 cases rise when non-members travel onto tribal lands. Our findings engage the literatures on Native American politics, health policy within U.S. federalism, and structural health inequalities, and should be of interest to both scholars and practitioners interested in understanding COVID-19 outcomes across Tribes in the United States.
... Indian Health Services is responsible for the coercive sterilization of Native women in the 1960s and 1970s; this continued at least into the 1990s (Gurr 2012;Johansen 2001;Langston 2003;Lawrence 2000;Smith 2005;Torpy 2000). Similarly, the University of Southern California, Los Angeles Medical Center, coerced and forced Chicana women into sterilization; cases from the 1970s are documented in the 1975 lawsuit Madrigal v. Quilligan (Madrigal 1975). ...
Chapter
This chapter provides examples of health research and healthcare abuses of people of color and considers how these legacies of violence impact health care’s current capacity to serve trafficked people. The reader will learn examples of how, historically, people of color were forced and manipulated into participating in human subject research and used for medical education without reaping the benefits of healthcare improvements based on the use of their bodies. In some cases, the guise of healthcare provision has been used to perpetuate acts of genocide against communities of color. Health care’s history of abuse bleeds into the contemporary failures to properly serve people of color and people with a trafficking experience. The chapter also provides specific recommendations for the fields of education, public health, research, health care, and immigration law to advance the goal of sustainable trafficking abolition.
... The legacy of the study can be still felt, for instance in distrust in HIV treatment and prevention (Johnson, 2000) and COVID-19 vaccination (Letzing, 2020). Indigenous peoples in Canada and the United States were the subjects of similar unethical treatment by the medical community, such as nutritional experimentation on Indigenous children at residential schools (MacDonald et al., 2014) or the forced sterilization of Native American and Indigenous women in the 1970s (Lawrence, 2000). Although we are not suggesting that negative experiences with the biomedical community directly shape distrust in water (although they may), our case examples demonstrate that negative historical experiences related to water insecurity have enduring effects on trust in water, as well as the ways that broader experiences of this type may have long-term and far-reaching effects on other aspects of institutional trust. ...
Article
Full-text available
Assumptions of trust in water systems are widespread in higher-income countries, often linked to expectations of “modern water.” The current literature on water and trust also tends to reinforce a technoscientific approach, emphasizing the importance of aligning water user perceptions with expert assessments. Although such approaches can be useful to document instances of distrust, they often fail to explain why patterns differ over time, and across contexts and populations. Addressing these shortcomings, we offer a relational approach focused on the trustworthiness of hydro-social systems to contextualize water-trust dynamics in relation to broader practices and contexts. In doing so, we investigate three high-profile water crises in North America where examples of distrust are prevalent: Flint, Michigan; Kashechewan First Nation; and the Navajo Nation. Through our theoretical and empirical examination, we offer insights on these dynamics and find that distrust may at times be a warranted and understandable response to experiences of water insecurity and injustice. We examine the interconnected experiences of marginality and inequity, ontological and epistemological injustice, unequal governance and politics, and histories of water insecurity and harm as potential contributors to untrustworthiness in hydro-social systems. We close with recommendations for future directions to better understand water-trust dynamics and address water insecurity.
... However, community-informed and resilience research about Indigenous women's reproductive and sexual health is scarce (Gurr, 2014). To our knowledge, this research is the first to look at this topic among state-recognized tribes in the Gulf Coast, and among the foremost to look at the topic of sexual and reproductive health among Indigenous women more broadly and holistically (i.e., beyond discussions of the history of sterilization and maternal mortality rates), especially for tribes outside of the Indian Health Service (IHS) system (Gurr, 2014;Krieger & Fee, 1994;Lawrence, 2000;Theobald, 2019;Torpy, 2000). In this article, we describe the development of the FIRSHT, which incorporates key components of the reproductive justice, resilience, Indigenous critical theory, life course, and eco-systemic theoretical frameworks. ...
Article
Full-text available
Introduction Indigenous women experience extensive reproductive health disparities and reproductive oppression. Theoretical frameworks for understanding the complex intersection of factors that contribute to these experiences are needed, especially those that highlight the resilience of Indigenous peoples throughout settler colonialism. The purpose of this article is to explore the empirical development of the Framework of Integrated Reproductive and Sexual Health Theories (FIRSHT) to contextualize and understand the reproductive and sexual health experiences of Indigenous women. Methods The FIRSHT was developed through a qualitative descriptive research study with 31 Indigenous women from a Gulf Coast tribe. Interviews were conducted in 2018 and 2019. The first author partnered with a community-advisory board throughout the research project, and in the dissemination of results to tribal members. Results After presenting a snapshot of the overarching results, we discuss how the FIRSHT incorporates key components of the reproductive justice, resilience, Indigenous critical theory, life course and eco-systemic theoretical frameworks. The proposed framework conceptualizes the interrelationship of factors that impact women’s reproductive and sexual health experiences. Discussion This research fills a gap in the need for holistic understandings of Indigenous women’s reproductive and sexual healthcare required for the development of interventions that not only address social justice issues and weaknesses in the healthcare system but also promote the existing strengths and resources in Indigenous communities. Policy Implications This theoretical framework may be useful for researchers interested in studying the reproductive and sexual health experiences of Indigenous women, who desire a holistic and strengths-based framework.
... In this vignette, Dr. Campbell centers the elusive ethical dimension of professional practice to recognize interpersonal dignity and trauma, as she narrates the case of an Indigenous woman who suffered for a long time from an underdiagnosed case of rheumatoid arthritis. But her pain, as we will see in this case, is not merely a matter of being diagnosed in the moment, rather it is deeply connected with the history of disciplinary violence of Western medicine on Indigenous bodies (e.g., see Lawrence, 2000;Lux, 2016). Dr. Campbell learned that the patient felt traumatized every time her previous doctor, a white male person, turned his back towards her to draw up a syringe during a clinical procedure, evoking painful memories of the violent use of Indigenous bodies for medical experimentation. ...
... In this vignette, Dr. Campbell centers the elusive ethical dimension of professional practice to recognize interpersonal dignity and trauma, as she narrates the case of an Indigenous woman who suffered for a long time from an underdiagnosed case of rheumatoid arthritis. But her pain, as we will see in this case, is not merely a matter of being diagnosed in the moment, rather it is deeply connected with the history of disciplinary violence of Western medicine on Indigenous bodies (e.g., see Lawrence, 2000;Lux, 2016). Dr. Campbell learned that the patient felt traumatized every time her previous doctor, a white male person, turned his back towards her to draw up a syringe during a clinical procedure, evoking painful memories of the violent use of Indigenous bodies for medical experimentation. ...
Conference Paper
Full-text available
This paper highlights the ethical and moral dimensions of relational work and dignity in technoscientific spaces which are elusive in normative disciplinary practices. Using the lenses of ethical perceptions and embodied actions, we locate how microinteractions within physician-patient interactions during pain diagnosis and care are intertwined with interpersonal dignity, racialized emotions and historicized violence on Indigenous people. We discuss the implications of our work in light of dismantling normative views of disciplinary authenticity that underlie technoscience education.
... In conceptualizing this special issue on healthcare, we emphasize the urgency of centering bodyminds 2 and communities whose lives and experiences have been disregarded, or viewed as disposable, in medical communication and other TPC. Beyond the medical field's penchant for centering white cisgender men (Dusenbery, 2018;Jackson, 2019), medical communication and other TPC have also long functioned as the invisible hand of biopower--e.g., in gynecological medicine's progress narratives that intentionally erase its history of torturing and abusing Black cisgender women (Ivy, 2016;Owens, 2017;Washington, 2006); trans healthcare researchers' disavowal of the white supremacist origins of gender-affirming treatments (Gill-Peterson, 2014Hsu, 2019;Snorton, 2017); HIV public health campaigns that continually traffic in racism, misogynoir and transphobia (Bailey et al., 2019;D'Avanzo et al., 2019;Jeffries & Henny, 2019;Mulé et al., 2009;Rosen et al., 2019;Young & Meyer, 2005); the Supreme Court's (1927) Buck v. Bell ruling that legalized the forced sterilization of Black, Brown, Indigenous, and incarcerated women and dfab people (Davis, 2018;Dow, 2018;Lawrence, 2000;Luna, 2009;Scully, 2004;Whatcott, 2018); decades of government policy that has intentionally underfunded the Indian Health Services (Jaramillo & Willging, 2021;Lewis, 2018;Sarche & Spicer, 2008); medical and nursing schools which enshrine and continually fail to interrogate their white supremacist curricula (Beagan, 2003;Brooks, 2015;Loder et al., 2020;Scharff et al., 2010;Zappas, Walton-Moss, Sanchez, Hildebrand, & Kirkland, 2020); and calls for participants which intentionally frame BIPOC and LGBTQ patients as unideal candidates for clinical research (George, Duran, & Norris, 2014;Rabelais & Walker, 2021;Washington, 2006). ...
Article
In this introduction, we emphasize the urgency of centering bodyminds and communities whose lives and experiences have been disregarded, or viewed as disposable, in medical and technical communication. With an expansive vision of health, we set the interdisciplinary stage for authors who answer the call of multiply-marginalized scholars working in (and beyond) medical rhetorics to reimagine health-related research that centers the perspectives, experiences, and embodied realities of multiply-marginalized communities (Jones, 2020 Jones, N. N. (2020). Coalitional learning in the contact zones: Inclusion and narrative inquiry in technical communication and composition studies. College English, 82(5), 515–526.[Web of Science ®] , [Google Scholar]; Walton, Moore, Jones 2019 Walton, R., Moore, K., & Jones, N. (2019). Technical communication after the social justice turn: Building coalitions for action. New York: Routledge.[Crossref] , [Google Scholar]).
... Despite the aforementioned health disparities, and the potential for sexual health education and increased communication about these topics to improve health outcomes, little research explores the sexual health education experiences of Native American women. To our knowledge, there is no existing research on this topic among tribes that are state-recognized in the Gulf Coast, and there is little research on reproductive and sexual health education among Native American women, with most research focusing on the experience of sterilization (Gurr, 2014;Krieger & Fee, 1994;Lawrence, 2000;Ponzetti & Abrahamson, 1990;Shegog et al., 2017;Theobald, 2019;Torpy, 2000). This study addresses the following research question: "What are the beliefs about sex and contraception, sexual health knowledge, and sexual health education for women in this Gulf Coast Native American tribe?" ...
... However, these are the same forces that wrote medicine's violent history and continue to uphold inequitable healthcare systems. The catch-all term, "diversity, equity and inclusion" can thus allow institutions to hide behind language and skirt the difficult work of examining and uprooting the foundations upon which medicine has accumulated and concentrated power (43)(44)(45)(46)(47)(48). ...
Article
Full-text available
While the number of positions, committees, and projects described as “Diversity, Equity, and Inclusion (DEI)” work has grown rapidly in recent years, there has been little attention to the theory, praxis, or lived experience of this work. In this perspective, we briefly summarize the research and concepts put forth by DEI leaders in higher education more broadly, followed by an analysis of the literature's application to academic medicine. We then discuss the ways in which language obscures the nature of DEI and the necessity of scholarship to evaluate the extensive range of practices, policies, statements, and programs the label is given to.
... Meanwhile, eugenics practices flourished and were affirmed in the 1927 Supreme Court decision in Buck v. Bell which upheld the legality of forced sterilization [14,16]. In 1942, in Skinner v. Oklahoma, the Supreme Court ruled against compulsory sterilization of convicted criminals but did not address the forced sterilization of other populations (e.g., based on income, minority status, or mental illness) [14,15,17]. These practices continued for many years, and reports of the forced sterilization of imprisoned populations and coercion involving incentives to promote permanent or long-acting contraception continue to emerge [16,18]. ...
Article
Full-text available
Background: Contraceptive access is influenced by policy decisions, which can expand and constrict the contraceptive options available. This study explored the impact of recent US federal policy on contraceptive access. Methods: Federal policy changes impacting contraceptive access over the past decade were identified in grey literature. These policy changes were organized into a timeline and analyzed according to Levesque et al.'s (2013) five dimensions of healthcare access (approachability, acceptability, availability/accommodation, affordability, and appropriateness), noting the most salient healthcare dimension impacted by the policy change and analyzing whether, according to this framework, the policy created a theoretical increase or decrease in contraceptive access. Results: Of those policy changes coded as increasing (n = 42) and decreasing (n = 28) contraceptive access, most were related to the affordability (increasing n = 13; decreasing n = 12), physical availability (increasing n = 10; decreasing n = 7), and appropriateness (increasing n = 12; decreasing n = 4) of contraceptive care. Policy changes largely followed partisan divides, with contraceptive access increasing in years with a Democratic president and decreasing when a Republican president was in office. Many policy changes were related to the Affordable Care Act (ACA) and Title X of the Public Health Services Act. The implementation of the ACA and subsequent updates to it have increased the affordability of contraception, whereas changes to Title X have decreased the availability and appropriateness of contraceptive care. Conclusions: This study highlights recent policy changes impacting contraceptive access, organizing them according to the five dimensions of healthcare access. It outlines specific policy barriers to contraceptive access and provides suggestions for policy and practice action that will improve contraceptive access and reproductive autonomy. Opportunities to ensure contraceptive access for all Americans include promoting comprehensive sex education, extending the Community Health Center Fund, increasing contraceptive care options for people with employers who are exempted from the ACA contraceptive mandate, addressing discrimination and building trust in contraceptive care, and amplifying outreach efforts to combat misinformation and confusion created by continuous changes to key family planning policies. Continued research on the role of policy in determining reproductive autonomy is warranted, and practice and policy action is needed to improve contraceptive access.
Chapter
This chapter opens with a discussion by Dr. Locust on despair, trauma, and suicide as well as a discussion of post-colonization stress disorder. This chapter examines the health disparities between Indigenous communities and their demographic counterparts, which are a direct result of colonization. The chapter gives statistics on physical and mental health differences including suicide rates and examines the relation of these to the lack of Indigenous data sovereignty. Colonization practices of eugenics are described as they relate to physical and mental intergenerational trauma. The chapter concludes with a discussion of Indigenous understandings of wellness and difference as a way to advance current Western dialogues involving illness and disability.
Article
There is growing scholarly and public attention toward the stark racial disparities in birth outcomes in the US. To lower disparate rates of Indigenous and Black infant mortality rates and maternal mortality rates, public and elected officials have proposed extending comprehensive prenatal care and medical resources and addressing racial biases in healthcare delivery. These efforts aim to bring minoritized and marginalized peoples and communities “into the fold.” In this essay, I consider the potential dangers of such contemporary efforts by critically analyzing historical initiatives to address birth outcomes and reproductive health in Indigenous communities. By foregrounding settler colonial social orders and their links to settler capitalism, I show how historical efforts to bring Indigenous peoples “into the fold” jeopardized Indigenous birth and reproductive capacities, while also upholding heteropatriarchal notions of sexuality, family, and racial difference.
Article
In 1996, Alberto Fujimori introduced the National Program for Reproductive Health and Family Planning 1996–2000, the first publicly funded family planning program in Peru’s history, under which at least 10,000 Indigenous women were forcibly sterilized. This program was aided by what I came to identify as the Reproductive and Sexual Rights (RSR) assemblage – a group of feminists working in reproductive and sexual rights in Peru. This was made possible by Fujimori’s co-optation of the reproductive rights discourse and the rise of neoliberal governmentality, which enlisted the expertise of non-state actors in projects of governance. Moreover, in their heartfelt desire to bring reproductive rights to Peru, the RSR did not appreciate Indigenous women’s inclusive exclusion from citizenship – their inclusion in the settler colonial nation as marginal members whose bodies could be instrumentalized for national projects. Through the National Program, Fujimori instrumentalized Indigenous women’s bodies to create statistics showing a reduction in poverty for international lenders. A similar reading of the RSR’s actions is possible. By downplaying the magnitude of the forced sterilizations in the late 1990s, the RSR unwittingly contributed to the violation of Indigenous women’s rights in the name of extending reproductive rights to ‘all Peruvian women.
Article
Purpose Differences in hysterectomy prevalence by rural or urban residence could distort comparisons of rural-urban cervical and uterine cancer incidence. Using data from a large population-based survey, we sought to understand whether hysterectomy prevalence varies by rural or urban residence and whether the relationship between hysterectomy prevalence and rurality varies by race or ethnicity. Methods Our analysis included 197,759 female respondents to the 2018 Behavioral Risk Factor Surveillance System, aged 20-79 years. We calculated population weighted proportions and 95% confidence intervals for hysterectomy prevalence, stratified by rural-urban residence and 5-year age groups. We also report estimates of hysterectomy prevalence by rural-urban residence for specific race and ethnic groups. Findings Hysterectomy prevalence increased with age and was more common among rural women than urban women. The largest absolute difference occurred among women aged 45-49 years; 28.6% of rural women (95% CI: 25.1-32.2) and 16.6% of urban women (95% CI: 15.3-17.8) reported a hysterectomy. For hysterectomy prevalence by race and ethnicity, rural estimates were higher than urban estimates for the following groups of women: non-Hispanic Asian, non-Hispanic other race, non-Hispanic Black, and non-Hispanic White. Among Hispanic women and non-Hispanic American Indian/Alaska Native women, rural-urban differences in hysterectomy prevalence were not statistically different at the 95% confidence level. Conclusions Our results suggest that variation in hysterectomy prevalence, if not adjusted in the analysis, could produce distorted comparisons in measures of the relationship between rurality and uterine and cervical cancer rates. The magnitude of this confounding bias may vary by race and ethnicity.
Article
Joan Burbick reads Jay Harjo from a queering as well as post-colonial perspective, analyzing the way in which normative discourses of social cohesion are questioned and re-formulated from the vantage point of Native American categories such as the berdache. Harjo's vision promotes radical contingency and a seemingly spiritual notion of transference.
Article
Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.
Chapter
This chapter examines unique challenges in the way of Native American educational success as well as solutions to overcoming. The chapter addresses why intergenerational trauma matters, the impacts of public policy on Native American people such as the Native American Languages Act of 1990, and the importance of Native American people being connected to the land, protecting traditions, language, and their ancestors. The purpose of this literature review is to shed light on Native American educational barriers and to critique existing literature. Areas analyzed include the trend of low rates of educational attainment among Native Americans, the history of abuse towards Indigenous people and other minorities, the impact on individuals, and solutions for the future. There is a need for Native American students to stay connected to cultural tradition, cultural relevancy in education, role models for Native American people, and an importance of Native American students staying connected to family.
Article
Research related to racism and health has evolved in recent decades, with a growing appreciation of the centrality of the social determinants of health, life-course approaches and structural racism, and other upstream factors as drivers of health inequities. Examining how race, class, and structural racism relate to each other and combine over the life course to affect health can facilitate a clearer understanding of the determinants of health. Yet there is ongoing discomfort in many public health and medical circles about research on racism, including opposition to the use of racial terminology. Similarly, most major national reports on racial and ethnic inequities in health have given limited attention to the role of racism. We conclude that there is a need to acknowledge the central role of racism in the national discourse on racial inequities in health, and paradigmatic shifts are needed to inform equity-driven policy and practice innovations that would tackle the roots of the problem of racism and dismantle health inequities.
Article
Native Americans (the preferred term of our partners/co-authors) experience high rates of sexual violence, which is rooted in colonization and multiple historical traumas. Sexual violence leads to numerous deleterious outcomes, underscoring the critical need for prevention early in life. Yet, most research to date on sexual violence has not focused on Native American populations, and we know little about the most effective strategies to recruit and retain Native American individuals in sexual violence prevention research. The purpose of the current study, grounded in principles of participatory action research, is to describe strategies that were used to recruit (e.g., traditional feeds, door knocking) and retain (e.g., monetary incentives, ongoing community engagement) Native American youth for a study that sought to assess, via surveys and qualitative interviews, the impacts of a youth-led sexual violence prevention initiative in a small city in the Great Plains. We also collected qualitative data from Native American caregivers regarding their perceptions of research. Overall, 67.9% ( n = 545) of eligible Native American youth completed the survey, and school and door knocking were most effective methods of recruitment/enrollment followed by community and school events and texting. Over the course of 3 years of data collection, there were higher rates of attrition among Native American youth compared to white youth, and several factors (e.g., older age, sexual assault victimization) predicted attrition among Native American youth. Native American caregivers’ responses reflected on reasons it is hard to engage youth and caregivers in research (e.g., lack of time, distrust) as well as strategies to enhance engagement (e.g., personal connection, providing community resources). Throughout the paper, Native American co-authors and project partners reflect on these findings. Implications for future sexual violence prevention research with Native American youth and their caregivers that uses decolonized, participatory action research methodologies are discussed.
Article
The coronavirus disease 2019 (COVID-19) outbreak has ravaged the world, with numerous cases disproportionally attributed to the United States due to vaccine hesitancy. One vulnerable group that has been affected by vaccine hesitancy is the pediatric population, particularly those in racial and ethnic minority groups. To improve health outcomes and vaccination rates, we must first understand the factors contributing to vaccine hesitancy and its subsequent influence on the pediatric population. The medical community can better tailor public health strategies by analyzing historical and current events contributing to COVID-19 vaccine hesitancy. A comprehensive approach will improve the health of children and society as a whole. [Pediatr Ann. 2022;51(3):e107-e111.].
Article
Women's health, and what we know about it, are influenced by social factors. From the exclusion of women's bodies in medical research, to the silence and stigma of menstruation and menopause, to the racism reflected in maternal mortality, the relevance of social factors is paramount. After a brief history of research on women's health, we review selected patterns, trends, and inequalities in US women's health. These patterns reveal US women's poor and declining longevity relative to those in other high-income countries, gaps in knowledge about painful and debilitating conditions that affect millions of women, and deep inequalities that underscore the need to redress political and structural features of US society that enhance health for some and diminish it for others. We close by describing the challenges and opportunities for future research, and the promise of a social determinants of health approach for advancing a multilevel, intersectional, and biosocial understanding of women's health. Expected final online publication date for the Annual Review of Sociology, Volume 48 is July 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Article
This article expands upon the current theoretical construction of colonialism to make settler-colonial societies’ economic strategies more explicit. These strategies, which I term economic violence and economic hegemony, have been used by US federal and state governments to subvert the inherent sovereignty of Native Nations in order to access their resources. This paper also proposes and illustrates six categories of economic hegemony – debt creation, underfunding, mismanagement of funds and resources, blackmail, taxation jurisdiction, and regulation – to clarify the types of tools that settler-colonial states, like the United States, have available to accomplish their goals. Significantly, however, the illustrative examples also foreground Native Nations’ agency in countering and even anticipating US federal and state governments’ aggressions across time and geographies. Incorporation of these strategies into political and economic discourse leads to a more precise analysis of settler-colonial incursions while emphasizing the many ways in which Native Nations exert their sovereignty to forward economic justice.
Article
Race science attributes differences in human populations to biology and genetics that reflect a hierarchy of human races with whiteness at its pinnacle. This article examining the history of race science and current family scholarship and practice contends that race science matters for family science. We discuss (1) white supremacy, the development of race science, and the eugenics movement in the U.S.; (2) racism, racialized experiences, and oppression of Black families in the U.S.; (3) the construction of whiteness in family science and re‐envisioning theories to make racism's impact visible; (4) racial reckonings for professional organizations; and (5) why race science matters for family science and a call to action. Clarity about the meaning of race can ensure that family science addresses white supremacy and racism embedded in scholarship, training, and practice, and promotes work that supports the well‐being of families that are most vulnerable and marginalized.
Article
This interdisciplinary historical paper focuses on the past and current state of diverse forms of surgical hysterectomy as a global phenomenon relating to population control and sterilisation. It is a paper grounded in historical inquiry but is unconventional relative to the norms of historical scholarship both in its wide geographical scope informed by the methodologies of global and intercultural history, in its critique of current clinical practices informed by recent feminist, race, biopolitical and disability studies, and by its engagement with scholarship in health sociology and medical anthropology which has focused on questions of gender and healthcare inequalities. The first part of the paper surveys existing medical, social-scientific and humanistic research on the racial, class, disability and caste inequalities which have emerged in the recent global proliferation of hysterectomy; the second part of the paper is about the diverse global rationales underlying radical gynaecological surgeries as a form of sterilisation throughout the long twentieth century. Radical gynaecological surgeries have been promoted for several different purposes throughout their history and, of course, are sometimes therapeutically necessary. However, they have often disproportionately impacted the most disadvantaged groups in several different global societies and have frequently been concentrated in populations that are already maligned on the basis of race, ethnicity, age, criminality, disability, gender deviation, lower class, caste or poverty. This heritage continues to inform current practices and contributes to ongoing global inequalities of healthcare.
Chapter
This chapter conceptualizes reproductive violence as a distinct form of gender-based violence that is not necessarily committed in a sexualized manner. Its unique characteristic is the underlying violation of reproductive autonomy, understood as the freedom to choose whether, how, and under what circumstances to reproduce. Conflict-related reproductive violence may occur in various manifestations. This includes, for example, forced sterilization as a negative form and forced pregnancy as a positive form of reproductive targeting, which have been documented throughout history. Nevertheless, reproductive violence has rarely been addressed within the international criminal legal discourse. While post-World War II trials set important precedents particularly with regard to the act of forced sterilization, the prosecution of reproductive violence under international law has thus far remained limited to genocidal or similar group-related scenarios. Giving an overview on historical documentations of conflict-related reproductive violence and transferring insights from the discourse on reproductive human rights, this chapter argues that international criminal law and practice should address reproductive violence as a violation of reproductive autonomy independently of its possible collective dimension.
ResearchGate has not been able to resolve any references for this publication.