Michael Bird
Throughout
his distinguished career in public health, Michael
Bird, Santo Domingo, San Juan Pueblo, MSW, MPH, has
been working to enhance the health of the public,
particularly the health of American Indian and Alaska
Native people. From 1998 to 1999 he was the first
American Indian (and the first social worker) to serve
as President of the American Public Health Association
(APHA), an internationally respected organization with
more than 50,000 members that has been influencing
policies and setting priorities since 1872. Bird was
elected President of APHA after decades of working in
program development and health policy at the tribal,
state, and national level. When the following article
was published, Bird was the executive director of the
National Native American AIDS Prevention Center
(NNAAPC).
Working to Eliminate Health Disparities
Michael Bird,
Santo Domingo, San Juan Pueblo, MSW, MPH, is well known for
his work in overcoming health disparities. He asserts, “The
massive dispossession that removed native people from their
ancestral lands and took away their language, culture, and
labor resulted in significant damage in health, in
educational levels, and in social well-being. This
phenomena of dispossession followed by disparity has
occurred not only with Native Americans, but with Native
Hawaiians, Australian Aborigines, the Maori of New Zealand,
and many other indigenous people throughout the world.
For decades Bird has been arguing that indigenous people
deserve their fair share and that their wisdom is needed by
the larger society. "Raising the public's awareness of
health disparities is vital," he says. "Our task is to
reach and educate people and organizations and all branches
of the federal, state, and local governments. We must help
them understand who we are and how we have been affected.
We must assume that bringing together the data and
political process with wisdom and heart is a do-able task."
Being
at the table
When health policy makers sit down together to try to
figure out solutions to the problems connected with
disparity, Bird insists that indigenous people should
participate. "Because of our small numbers and the relative
poverty of tribes, we're not invited to the table to offer
our perspectives. People don't remember we were the first
people here. We should be the first ones invited."
When planning services or examining disparities, Bird says
that new models should be used that are based on
commitments to inclusiveness, diversity, and social
justice. He says we need to “avoid models that are based on
who has the most power, the most money and the most friends
in influential places.”
Bird recommends encouraging American Indian and Alaska
Native people to enter the field of public health in order
to make sure that indigenous health disparities are
acknowledged and addressed. Generating more scholarship
dollars to support these students is essential.
Bird also recommends creating opportunities for Natives and
non-Natives to meet, talk, and know one another’s stories
and issues.
"Above all," urges Bird, "We must maintain our commitments
with our indigenous communities and be supportive of each
other. We are not the sum of our disparities. Together we
are strong and capable."
Beginnings
What led Bird
into health care? Why is he such a passionate advocate for
indigenous people, even in the face of opposition and
disapproval?
“Part of my reality is that I grew up with a father who was
an alcoholic,” says Bird. “It was unfair to be a child in
that position. But it also gave me a sense of the
difficulties many people face and a desire to make a
positive difference in their lives.”
One of the challenges that Bird and his family had to face
was his fathers’ joblessness when Bird was 5-years old.
Bird credits his grandmother with helping him because a
"resilient" child, even when others were telling him that
he wouldn't succeed or be good enough. Bird was also
nurtured by his mother's love and inspired by how she
worked for the Bureau of Indian Affairs in Utah for almost
30 years, raising him and his sister on her own.
Education
Bird earned his
bachelor’s degree in anthropology and his master’s in
social work (MSW) at the University of Utah. He returned to
Santa Fe where he was a medical social worker in Santa Fe
Indian Hospital, which serves 11 Pueblos and the Jicarilla
Apache Tribe.
After 5 years, Bird says, “I got burned out. Being
young and idealistic, I probably did more than I should
have.” He also realized that the health care system was
flawed. “I wanted to work on a larger scale, addressing
policy and other issues. To do that I realized that I
needed a better understanding of health care and other
credentials. Social work was a good foundation, but I
wanted more tools and some other ways of looking at health
care.
“Some friends with degrees in public health recommended
that I consider public health. Since I wanted a degree that
was marketable but wouldn’t keep me in school too long, a
masters degree in public health seemed like a natural
progression.”
Bird attended the School of Public Health at the University
of California at Berkeley. There he developed a broader
vision of health and community. “The program reaffirmed
some things I already knew. Indigenous people have always
known about systems. We recognize that everything is
interrelated and interconnected. That’s an indigenous
worldview. Chief Seattle articulated this view long ago.”
After getting his MSW, Bird was unemployed for 9 months. He
had intended to take a couple month break and then work
again for IHS, but it didn’t work out that way. “When I
left IHS to go to school, I had written a little article, a
manifesto. In it I shared my perspectives on the way the
system operated. When I came back, some people were still
angry.”
Return
to IHS
During his
search for employment, Bird was reminded of the importance
of having supportive people in one’s life. The late Dr.
Jonathan Mann, New Mexico’s first epidemiologist in the
state health department and later an international leader
in the HIV prevention and treatment, helped Bird recognize
his talents and find work.
Bird did get back into IHS and advanced quite quickly. In
1984 as evaluation officer in the Office of Evaluation and
Planning, he assessed existing programs and made
recommendations. In addition, Bird established the
Albuquerque Area IHS employee health promotion program
model and served as a project officer on a family alcohol
abuse, child abuse and neglect project.
In his next position as associate director of tribal
activities, he was the liaison between IHS and 27 tribes in
four states. He was instrumental in refining and
coordinating preventive health programs and working on-site
with tribes and IHS representatives to facilitate better
communication and increase the effectiveness of the
programs. He also developed and co-produced “Windrunner” a
widely-distributed video promoting healthy lifestyles
through the ancient tradition of Indian running.
Bird moved on to become associate director in the Office of
Preventive Health programs. There he directed 8 preventive
health programs, again for the 27 tribes. He also
established collaborative working relationships among
state, tribal and non-profit agencies to create health
promotion and disease prevention programs.
After serving in two other positions, he became associate
director of the Office of Preventive Health Programs in the
area office. He was in that position until 1995 when his
frustration with bureaucracy led to problems. “I learned
that bureaucratic systems don’t always value independent
thought and work,” says Bird. “Eventually I ran into some
difficulty and sort of got the boot. It wasn’t based on my
ability or performance. It was an internal political
thing.”
Bird went back to Santa Fe. There he became Director of
Preventive Health Programs for the Santa Fe Service Unit.
In this position, which he held for 5 years, he was
responsible for the administration, management and
evaluation of substance abuse, social work, health
education and nutrition programs for 25,000 members of 12
New Mexico tribes.
Working
on a State and National Level
In the mid
1980s when Bird returned to New Mexico and began working
again for IHS, he decided it was important to build
relationships with health workers on the state and national
level. He joined the New Mexico Public Health Association
and eventually became its president. When Helen Rodriguez
Trias, the first Latina President of American Public Health
Association, visited New Mexico, she encouraged Bird to
become an executive board member of the APHA. “I didn’t
think there was any way I could win,” says, Bird. But he
did win this national level position and became only the
second American Indian to be a member of this prestigious
board. In 1998, his peers appointed him chairperson of the
executive board.
President
of the American Public Health
Association
In 1999 Bird
was elected to the highest position in the APHA. While
serving as president-elect, he announced that his
priorities were (1) to create an awareness of indigenous
health concerns and (2) to eliminate racial and ethnic
health disparities. Bush pushed his agenda by speaking
publicly all over the country to groups of health
professionals, administrators, policy makers and others who
could influence healthcare programs and health policy. Bird
also made sure that a 2002 issue of the American
Journal of Public Health was devoted to
indigenous health.
At the APHA’s 129th
annual meeting,
Bird brought together a panel of indigenous leaders in
public health from the continental United States, Hawaii,
Canada, and New Zealand. At a plenary session, the
panelists discussed “Indigenous Perspectives on Health:
Modern Problems and Ancient Solutions”. Bird
remembers, “As we shared our experiences as indigenous
people from a variety of settings, we gained a sense of
community, brought closer by the threat of the power of
ignorance and hate, and by the unacceptability of despair
and disparity." Panelists found that their historical
experiences had been very similar, including the fact that
prior to contact, their populations had been relatively
healthy.
Although Bird accomplished a great deal during his
presidency, he was frustrated that he couldn't do more.
When first elected president, Bird thought that leaders in
the Indian Health Service would see his three years at the
helm of APHA as an opportunity to develop a working
relationship with the largest public health organization in
the world. “I was wrong,” he says. “It was very
disappointing. We really could have moved an agenda. We
lost an opportunity to help our people. It wasn’t a lost
opportunity for me, though. I had a great time.”
National
Native American AIDS Prevention Center
As executive
director of the National Native American AIDS Prevention
Center (NNAAPC), Bird hopes
to build on the organization’s outstanding work since
its founding in 1987. Unlike most people in the United
States, those who started NNAAPC were aware of the
growing magnitude and severity of the AIDS pandemic.
Bird wants more people, including policymakers and
funding agencies, to be aware of NNAAPC and the health
disparities facing Native people. He wants to strengthen
NNAAPC’s infrastructure and, in turn, he wants NNAAPC to
be able to help tribes and other Native organizations
strengthen their infrastructures so they can compete
more successfully for the dwindling financial support
from governmental and private agencies. In addition,
Bird wants to broaden the mission of NNAAPC so its staff
can work with Native people in addressing the contextual
issues, such as poverty and this history of oppression,
which make Native people more vulnerable not only to
HIV/AIDS but also a wide range of health problems.
Causes
for Optimism
Bird points out
that the problems that exist in many Indian communities
didn’t start recently. The problems are longstanding, so it
will take time and work to make needed changes. But he sees
room for optimism, “There are a lot of positive things
going on in Indian communities that you didn’t see in the
past. For example, when I started in the Indian Health
Service years ago, a lot of communities wouldn’t
acknowledge that they even had problems. Now people are
much more open about problems, such as substance abuse.
"Another cause for optimism is that young Indian
professionals and nonprofessionals are working together to
define and solve the problems in their communities. In the
past, someone from the outside defined the problems and
brought in the solutions. Now the community defines the
problems and comes up with its own solutions.
There’s a whole history of Indian people having things done
to them, but it comes back to what you do to yourself.
People can define you and name you, and that gives them
power, but only if you accept it. Only if you accept that
definition, that name, that role, do they really have any
ability to affect you. I see Indian and Native people
moving more and more toward becoming more self-assured,
more confident, and defining themselves on their own terms.
This article was originally published in the Autumn 2003
issue of
Winds of Change. (The cover
artist is John Gonzales, San Ildefonso Pueblo.)