Where Are the Native Americans? Early Priorities of the South Dakota State Medical Association

Our study examines the relationship between the South Dakota State Medical Association (SDSMA) and members of a historically marginalized group in the state. Through archival research and cultural analysis, we identify priorities of the South Dakota State Medical Association early on in its organizational development, and during key moments for Native American healthcare, reconstructing the relationship between the Association and this population in the early 20th century. Primary documents were derived from the SDSMA Collection housed at the Center for Western Studies (Sioux Falls, SD). By examining the SDSMA's priorities in comparison to federal level changes occurring with Native American healthcare, we identified time periods of interest, in particular, during 1882 to 1956. This period includes the institutionalization of Indian Health Services (IHS), a critical moment when one might expect the SDSMA to discuss issues relevant to healthcare in the state and the prevalent Native American people therein. References to Native American populations were of interest by either their lack of inclusion or through the particular nature of their presence in the archival material. We demonstrate that while the SDSMA showed strong involvement in legislation affecting the practice of allopathic medicine in South Dakota, no mention of any major Native American health initiatives was seen, even during the formation of the IHS. Our findings provide insight into the role of seemingly neutral organizational structures, such as professional associations, as they contribute to the persistence of systemic inequality.