Biocultural assessment of health strategies among the Caddo Indians of southwestern Oklahoma

Oklahoma is home to over fifty tribes or sovereign nations relocated during the era of U.S. Government removal. The tribes display their own unique cultural heritage, which combine elements of traditional culture with the frontier heritage of the American West. The health care context of these Native communities is pluralistic including elements of traditional health practices, intertribal health perspectives, and medical care delivery by the Indian Health Service and community health services. This case study is a biocultural evaluation of the health of the Caddo tribe utilizing historical reconstruction, ethnographic methods, qualitative, and quantitative methods of health characterization of the contemporary population. The orientation is integrative to understand what I term the health matrix of this population. The health matrix is the biocultural interface where the interaction of social processes and biopsychological relations is monitored through an understanding of how cultural and biological variables intersect and overlap. The purpose is to understand social and behavioral processes, specifically social relations and cultural support mechanisms, on biological health. The main goal of the dissertation was to track Caddo health through time and to develop a tribe-specific morbidity and mortality profile to understand contemporary health patterns and issues facing the tribe. Defining the limits of the Caddo sample population and distinguishing them from other Native Americans in the area was a catalyst for developing an Indian Health Service grant to assess the health needs of the local population and work toward community program development. Political economic factors influencing the tribe were instrumental in the execution and delivery of the research and served to highlight areas of tribal dynamics and contradictions. This case study allows for a consideration of cultural and personal context in health behavior and profiles. A broad range of methodological techniques were combined to understand the complexity of the health matrix within this community. Although specifically focused on one tribe, the dissertation has theoretical implications for communities grappling with implementing community health care programs. This work presents sociopolitical and personal issues that impact individual health, as well as community programs, and incorporates Native Americans and anthropologists, or other consultants who work within these communities