American Indian Culture and Research Journal

The decades after World War I saw significant shifts in federal Indian policy in the United States. During the 1950s, the federal government pursued a termination policy, which sought to assimilate Native Americans by abolishing special federal status and services for Indians. By the mid-1960s, federal officials had largely abandoned termination and replaced it with a self-determination policy. Self-determination involved the maintenance of special federal services and status for American Indians while allowing Native peoples and governments greater opportunities to shape policy. While there are numerous books and articles on the termination period, coverage of self-determination during the 1960s (at least prior to the emergence of the Red Power Movement) remains more limited. This study seeks to help fill this gap by examining the implementation of Indian health improvement policies and how those policies affected and were affected by two groups: the Five Tribes of Oklahoma and the Pueblos of New Mexico. More commonly known as the Five Civilized Tribes because of their willingness to incorporate aspects of white culture into their societies, the Five Tribes include the Cherokee, Choctaw, Chickasaw, Creek, and Seminole tribes or nations. The nineteen New Mexico Pueblos consist of Acoma, Cochiti, Isleta,Jemez, Laguna, Nambe, Picuris, Pojoaque, Sandia, San Felipe, San Ildefonso, San Juan, Santa Ana, Santa Clara, Santo Domingo, Taos, Tesuque, Zia, and Zuni. Admittedly, many factors influenced Indian health and the development and implementation of health care policies. Three key aspects of Indian health for the Five Tribes and the Pueblos during the period between 1954 and 1968, include gains in health levels, a continued gap between Indian health levels and those of the general population, and the expansion of Indian health services in response to these Natives’ demands. The improvements in Indian health resulted largely from changes made by Congress in the Indian health care system-changes Congress saw as a prelude to termination. Ironically, the improvements in Indian health brought about by those changes, in combination with other factors, prompted the Five Tribes and the Pueblos to demand expanded services and to exert greater say over the development and delivery of those services. In other words, policies designed to lead to the termination of federal services instead resulted in expanded federal responsibility and greater Native American self-determination.