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November 1, 1971

Medical News

JAMA. 1971;218(5):665-674. doi:10.1001/jama.1971.03190180007003

Health representative: a new tribal role  Virtually everyone involved with the Indian Health Service agrees on one point, at least: the need for "community involvement.""Community involvement" is a term with many definitions. To a clinician burdened with non-clinical tasks while facing acutely ill patients, it means more clerical and paramedical support. To a sanitarian, it means a way to get money for safe wells and sewers. To a tribal leader, it means finding jobs for his people to get them out of the cycle of poverty that traps them in a way of life that makes poor health inevitable. To a public health nurse, it may mean finding a reliable way to get pregnant women to the hospital over bad roads or through countyside with no roads at all.To the patients—the Indians who live on the reservations scattered through 23 states—"community involvement" means finding someone who speaks their