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Disease Change and the Role of Medicine

The Navajo Experience

Stephen J. Kunitz

Publication Year: 1983

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.

Published by: University of California Press

Title Page, Copyright, Dedication

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pp. i-vi

Contents

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pp. vii-viii

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Acknowledgments

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pp. ix-x

...friends and colleagues have helped with various aspects of this work, and it is with pleasure that I acknowledge their assistance. Much of the early data collection was done with the financial support of grant GI-34837 from the National Science Foundation. That was my piece of a large study called the Lake Powell Research Project which brought together in an unlikely consortium...

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Introduction

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pp. 1-7

...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...

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1. Mortality, Fertility and Social Organization

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pp. 8-25

...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...

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2. Economic and Demographic Change on the Navajo Reservation

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pp. 26-63

...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...

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3. Disease Patterns on the Navajo Reservation

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pp. 64-117

...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...

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4. Traditional Navajo Health Beliefs and Practices

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pp. 118-145

...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...

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5. Health Care Utilization

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pp. 146-178

...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...

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6. Changing Mortality and the Role of Medicine

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pp. 179-188

...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...

Appendix I: Data and Methods

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pp. 189-194

Appendix II: Additional Tables

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pp. 195-198

Notes

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pp. 199-202

References

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pp. 203-220

Index

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pp. 221-227


E-ISBN-13: 9780520909649
Print-ISBN-13: 9780520067899

Page Count: 232
Publication Year: 1983

Series Title: Comparative Studies of Health Systems and Medical Care