On the Transformation of Human Conditions into Treatable Disorders Peter Conrad Over the past half-century, the social terrain of health and illness has been transformed. What were once considered normal human events and common human problems—birth, aging, menopause, alcoholism, and obesity—are now viewed as medical conditions.
How did you become interested in public health law? Improving health care in Indian Country has always been a passion of mine so I naturally gravitated toward it throughout my career. Originally, I began my undergraduate degree as a chemistry major in preparation to become a dentist, since oral health care and preventive care services are scarce on reservations.
However, my professional focus changed to Indian law and policy after studying at the University of Hawaii and seeing that Native people across the country could benefit from advocacy at the national level.
Will you please describe your career path? There, I performed legal analysis on proposed legislation during the New Mexico legislative session. Will you describe your role and day-to-day responsibilities as government and Medicalization in current health policy affairs associate for the Navajo Nation and assistant judge for the Southwest Intertribal Court of Appeals?
Navajo Nation is the only Tribe that currently has a working office in Washington, DC, dedicated to advocating for federal legislation and policy initiatives that directly impact our citizens.
I work with elected Navajo Nation leaders to advise on initiatives that relate to health, education, and public safety. My daily work greatly varies between working with federal agencies, congressional leaders, Tribes, and national tribal organizations. Most of my work is centered on outlining political and policy ramifications to provide strategic recommendations on how the Navajo Nation addresses specific issues to benefit our citizens.
As a judge at the Southwest Intertribal Court of Appeals, I decide individual cases as part of a three-judge panel to help provide appellate resources to Tribes that lack financial means or governmental infrastructure to provide appellate services to their communities.
I am extremely passionate about my work to develop tribal court infrastructure and it provides me with another avenue to stay connected to my community in the Southwest while I am gaining professional experience in DC. Do you consider yourself a public health law practitioner? I have worked on, and continue to work on, public health law through my professional experience as a lawyer and policy advocate.
The health law issues that I work on directly impact not only Navajo Nation, but Indian Country as a whole. I find these issues are frequently exceedingly complex, but well worth the hard work to improve access to health care in rural communities across the United States.
Adequate health care in any economically developed country should be a fundamental right that all people have equal access to—it is the cornerstone of a civilized society. Why is working with tribal governments different from working with other US federal, state, or local governments?
Tribal governments are unique by way of their legal implementation and political affiliation to the United States government. Unlike any other group, Tribes have a government-to-government relationship with the federal government that is established through US Constitutional provisions, numerous treaties with individual tribal governments, federal statutes, U.
Tribes and federally recognized tribal members have a unique relationship with the United States that is not based on race, but a political and legal relationship.
Specifically, Tribes are unique to work with in general since they cannot levy income or property taxes so you have to be creative in finding solutions for funding public roads and public safety. How is public health and healthcare delivery unique in Indian Country? In the latter part of the nineteenth century, the federal government expanded healthcare services to Native Americans to address the spread of disease in overcrowded boarding schools.
The federal organization of these services vastly differs from any other healthcare services provided by the federal government due to the history and treaty negotiations between governments.
How does the trust doctrine relate to Medicaid eligibility? As federal policy, and because Congress acknowledges a special trust responsibility and legal obligations under the Indian Health Care Improvement Act, IHS provides healthcare services to 2. At the same time, Congress ensured that states would not have to bear any associated costs by reimbursing them percent of the Federal Medical Assistance Percentage for services received through IHS and tribal facilities.
Thus, any cuts to Medicaid would have a negative and colossal impact on the healthcare delivery systems in Indian Country. What are Medicaid work requirements, and how might they conflict with traditional American Indian and Alaska Native practices and cultures?
Instead, they lead to Medicaid disenrollment, which subsequently negatively impacts IHS services and disrupts the federal trust responsibility.
For example, the Navajo Nation suffers from a 42 percent unemployment rate, which drastically exceeds that of metropolitan areas located outside Indian Country. The Navajo Nation has critical infrastructure needs, and work requirements unfairly penalize individual Tribal members for not having access to these services.
Further, negotiations could be made with individual states to work with Tribes to monitor traditional employment opportunities, but states frequently lack these resources or may choose not to engage with tribal governments, which unfortunately is not uncommon practice in some locations.
How can individuals learn more about American Indian and Alaska Native public health? To have a full understanding of health care in Indian Country and its current development and potential policy changes, it is essential to have a full understanding of the history and legal framework of Tribal governments, federal relations, and the origins of the federal healthcare system.
Federal Indian policy, and subsequently Indian health care, has developed through several policy eras, creating the programs that we see today. Picking up an Indian law book and understanding this history is one aspect of comprehending the issue, but calling and visiting an IHS facility on a reservation and observing the lack of infrastructure and basic necessities is another.
You need both the historical background and personal experience to fully comprehend the ramifications of health policy—or of any policy changes made in Indian Country.
How have your experiences as a tribal member informed your legal practice and judicial activities? As an enrolled member of the Navajo Nation, I understand the difficulties and shortcomings that people back home face on a daily basis.Medicalization is a process by which human problems come to be defined and treated as medical problems.
It involves the application of a biomedical model that sees health as freedom from disease and is characterised by reductionism, individualism, and a bias toward the technological (Box 1).
This course is designed to provide students with an overview of current and enduring topics in the Ability to contextualize health policy debates and come to terms with the current health care reform effort.
SO Advanced Topics: Sociology of Health . Medicalization encourages the view that one can solve socioeconomic and racial/ethnic health status disparities through initiatives and policies that reduce disparities in health care access, use.
Changing Public Health Priorities From Medicalization to Improving Built Communities Laura Schultz, Brett Weed, Ashini Fernando, Carolyn Moore, Andrea Andersen, David Garcia Medicalization has greatly increased the emphasis on the delivery of clinical services to individuals, often at the expense of population-based solutions.
Feb 04, · Over the past half-century, the social terrain of health and illness has been transformed. What were once considered normal human events and common human problems—birth, aging, menopause, alcoholism, and obesity—are now viewed as medical regardbouddhiste.comed on: April 20, Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing.