The New England Journal of Medicine, launched in 1812, published thousands of articles related to 'Indians' (Indigenous people). Current NEJM issue article 'Indigenous Americans - The Journal's Historical "Indian Problem",Page 2, shows 8 word clouds from journal articls about Indigenous Americans in 25-year increments (1825 - 2000). Societal prejudices were clearly infused in medical care of marginalized people then and continues to the present.
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"In response to a 1969 exposé, “Medicine in the Ghetto,” one doctor reminded readers that “Hidden from public view and thus from public conscience, the first American, the American Indian, represents the poorest of the poor in this rich land and an undeniable indictment of our failure as a society.”(48) Even as this doctor condemned the erasure of Indigenous Americans, Indigenous activists demanded attention, launching the American Indian Movement and
asserting Red Power. Vine Deloria and other Indigenous scholars offered new histories focused on the experiences and abuses of Indigenous communities.(49) The 1975 Indian Self-Determination "and Education Assistance Act gave those communities more authority to manage their own affairs,including health care. Thinking about disease shifted as well. Physicians increasingly directed their attention away from genetic causes of health disparities and toward social determinants of health.
Nevertheless, problems grounded in dispossession and structural racism persisted. In 2005, Lakota physician Yvette Roubideaux described how her efforts to improve health care for the San Carlos Apache “were constantly thwarted by obstacles to good health that extended far beyond the hospital — problems whose roots lie in the high rates of poverty, unemployment,
alcoholism, and other ongoing public health crises.”(50) Indigenous Americans (1.7% of the population) remain underrepresented in medicine, accounting for 0.4% of the physician workforce(51) and 1.0% of first authors and 0.7% of senior authors in JAMA and the Journal.(52):
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