Analyze

Drawing on a long career as a Black critical health equity researcher, Bowleg quotes Black feminist Audre Lorde in arguing that the “master’s tools”—in order words, conventional theories and methods—"will never dismantle the master’s house”—intersectional structures of oppression from which health inequities are produced. Bowleg elaborates by explaining that conventional theories and methods “valorize almost exclusively individualistic and social cognitive approaches (Cochran & Mays, 1993; Weber & Parra-Medina, 2003); ignore the foundational roots of structural and intersectional inequality (Bowleg, 2012, 2020); center White, Western, cisgender male, middle-class, and heterosexual people and their experiences as normative (Henrich et al., 2010); prioritize amelioration, not transformation (Fox et al., 2009a); and view Black people primarily through the lens of deficit or pathology” (237).

Thus Bowleg offers 10 critical lessons for Black and other health equity researchers of color that she links with system and structural-level strategies. Bowleg also cautions that these lessons are risky and could damage one’s academic career—but that it is exactly this kind of risk that is necessary for change. Among these include: embrace critical perspectives, embrace a critical qualitative stance, learn research paradigms (e.g. positivist paradigm = a master’s tool, must learn to counter), foster community-based partnerships and collaborations, and highlight black communities’ strengths, assets, and acts of resistance. Bowledge also encourages researchers to “tell it like it is”: “Epistemological ignorance is one of the master’s most formidable tools. Epistemologies of ignorance refer to the examination of different types of ignorance and their production, maintenance, and functions (Sullivan & Tuana, 2007)” (239). Here, Bowleg emphasizes the importance of language by discussing how it can alternatively reveal or obscure structures of oppression as well as it shapes the nature of research.

Quoted from the front page of the website

"Our Mission ... to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Our Goal ... to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people."

The membership consists of American natives who would like to receive the benefits of this organization. To be eligible to be a member you must be "an Indian and/or Alaskan Native" evidenced by several factors including being a part of a tribe, living on reservation land, or living in the household of a native. The employees consist of federal healthcare professionals commissioned by the United States Public Health Service and Civil Service federal employees.

Representatives of the Indian Health Service have made numerous congressional testimonies and numerous pieces of legislation have been passes to support the IHS, however, it does not appear that any relate to emergency response or disaster.

The IHS mainly focuses on disaster prevention and preparedness with initiatives such as teaching children about illness prevention, teaching about safe drinking water and food safety, preventing the spread of disease, and preventing injuries. They also have a number of resources available to their members to connect with healthcare professionals. This seems to be a community awareness type approach that prevents the spread of disease by teaching the community. It resembles that of many healthcare systems and does not seem to suggest problems with other approaches.

Legislation including the Indian Healthcare Improvement Act and the Snyder Act are the bases on which the IHS was founded. The passing of the Patient Protection and Affordable Care act by President Obama is the cornerstone of the IHS, however no single event seems to shape the agency's way of approaching health.

The IHS is funded by Congress after being reviewed by The House, Senate, and Congressional committees annually. A budget is formulated by a division within the IHS for approval each year. This means that their way of thinking about disaster and health must be approved by Congress, since they are a Federal agency.

I could not find any data or reports on their website that have been collected to support their approach to healthcare other than the legislation previously mentioned.

The organization has done research and generated fact sheets on statistics like injuries, behavior health, and environmental safety.

The organization has the infrastructure of the Federal government, however they operate in areas that are more rural, including Alaska and the Southwest where environmental issues such as clean drinking water can be present, which they address in their community health approach. All members also are allowed access to the internet, which I'm assuming is available at each of their locations.