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
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
Currently he is a public health consultant.
Working to Eliminate Health Disparities
Michael E. 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."
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.
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.)
June, 2009 Dr. Bird received the prestigious University of California Berkeley School of Public Health Alumnus of the Year award. He was the first Native American to be honored and was called a “champion of Native American health.”