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Disease Change and the Role of Medicine

Disease Change and the Role of Medicine: The Navajo Experience

Stephen J. Kunitz
Copyright Date: 1983
Pages: 232
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  • Book Info
    Disease Change and the Role of Medicine
    Book Description:

    Stephen Kunitz's work raises crucial issues for public policy in the medical field, and will be valuable for social scientists, physicians, and health professionals concerned with the social context of public health and other medical facilities.

    eISBN: 978-0-520-90964-9
    Subjects: History

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-x)
  4. Introduction
    (pp. 1-7)

    Beginning in the seventeenth century in Western Europe and later elsewhere, human population began to grow at an unprecedentedly high and sustained rate. Though increased fertility has been implicated as one of the contributing causes, a continuous dramatic fall in mortality has been of at least equal and probably greater significance. The decline in mortality—what has been termed the epidemiological transition (Omran 1971)—has been the result of a decline in pandemics and epidemics of infectious diseases. As they have waned, man-made and degenerative diseases, often with a very significant psychosocial component to their etiology (Cassel 1970, 1974), have...

  5. 1 Mortality, Fertility, and Social Organization
    (pp. 8-25)

    Epidemic infectious diseases are relatively recent phenomena in human history. For most of man’s time on earth, populations were small, scattered, and dependent upon hunting and gathering. Those infectious diseases that affected humans were either the result of accidental infection by zoonoses or indolent infections that perhaps had evolved with humans from their primate ancestors. It was only as a result of the agricultural revolution 6,000 to 8,000 years ago and the consequent growth of sedentary populations large enough to support microorganisms specifically dependent upon human hosts that epidemics appear to have become part of man’s life (Cockburn 1963; Black...

  6. 2 Economic and Demographic Change on the Navajo Reservation
    (pp. 26-63)

    Navajos probably entered north-central New Mexico during the sixteenth century. As a result of pressure from other Indians, as well as from Spaniards, Mexicans, and Anglo-Americans, they moved southwest and by the first half of the 18th century, perhaps as early as 1706, they were at Canyon de Chelly (James and Lindsay 1973). A small number may have moved even farther west (D in fig. 2.1) as early as the 1620s (Kemrer 1974:127). From 1750 to 1799 the Navajos probably settled as far west as First Mesa, on what is now the Hopi Reservation (in D in fig. 2.1). By...

  7. 3 Disease Patterns on the Navajo Reservation
    (pp. 64-117)

    Mortality rates had already declined substantially by the mid-1950s when the Public Health Service assumed responsibility for services to Indian communities and began to record vital events. Nonetheless, the change in causes of mortality and morbidity that accompanied this decline continued. This transition is illustrated in table 3.1, which shows the proportionate distribution of deaths by cause among Navajos in 1954—1956, 1965—1967, and 1973-1975.

    The table shows the rapid decline in deaths from influenza, pneumonia, gastroenteritis and diarrhea, and the dramatic increase in accident mortality. Heart disease increases slightly, but because symptoms and ill-defined conditions still constitute about...

  8. 4 Traditional Navajo Health Beliefs and Practices
    (pp. 118-145)
    Jerrold E. Levy

    Throughout the greater Southwest it has been observed that “in spite of the complex intertwining of ideas, two separate lines of religious practice can . . . be followed out. Oversimplified, they are as follows: The agriculturists tend to develop communal ceremonies, the hunters, personal religious participation” (Underhill 1948:viii). Traditional Navajo religion is an amalgam of these two lines, for the Navajos, originally hunters from the north, mixed with the Pueblos, especially after the rebellion of 1680, and adopted many features of Pueblo religion. Navajo religion is directed toward the maintenance of harmonious relationships between man, nature, and the supernaturals....

  9. 5 Health Care Utilization
    (pp. 146-178)
    Helena Temkin-Greener

    Throughout the first half of the nineteenth century, the administration of Indian affairs was under the jurisdiction of the War Department. From time to time military physicians treated Indian patients, including giving smallpox vaccinations. In 1849 when Indian affairs were transferred to the Department of the Interior, civilian physicians were recruited, and within twenty-five years about half the reservations had a physician.

    Services increased slowly in the late nineteenth and early twentieth centuries. Small hospitals were first opened on the Navajo reservation around 1900. From 58 hospital beds in 1912, the number increased to 184 in 1920. This does not...

  10. 6 Changing Mortality and the Role of Medicine
    (pp. 179-188)

    I began with a comparison of current mortality patterns among several different tribes and showed that as epidemic infectious diseases have waned, man-made and degenerative diseases with an important psychosocial component to their etiology have become increasingly significant. Among the tribes considered in chapter 1, there is a relationship between prereservation patterns of ecological adaptation and contemporary mortality patterns, which I explained by the degree of fit between preexisting mechanisms of social control and the demands of reservation life.

    When I turned to an examination of Navajo economic and demographic patterns in chapter 2, it was to show that the...

    (pp. 189-194)
  12. APPENDIX II: Additional Tables
    (pp. 195-198)
  13. Notes
    (pp. 199-202)
  14. References
    (pp. 203-220)
  15. Index
    (pp. 221-227)