Abstract
The Yakama Indian Reservation is located on the Great Columbia Plateau of central Washington State.1 It is the home of fourteen diverse tribes and bands of Native Americans who once spoke several dialects of three distinct languages, including Sahaptin, Salishan, and Chinookan. These Indians form the Yakama Nation, and their health has been closely related to the creation and execution of the reservation system of the United States since 1855 when a few chiefs signed the Yakima Treaty.2 Beginning in the 1870s, the Office of Indian Affairs placed a large number of Indians onto a limited land base and during the late nineteenth and early twentieth centuries restricted their access to traditional foods and medicines off the reservation. Confinement on the reservation led to changes in subsistence, maternalchild care, and housing that contributed to infant deaths resulting primarily from pneumonia, gastrointestinal disorders, tuberculosis, heart disease, and syphilis (fig. 1). The modal age (the age that appeared most often) of death on the Yakama Reservation during the era from 1914 to 1964 was children under one year of age, with 631 (16 percent) of the 3,899 deaths arising from this age group. This was the largest number of deaths suffered by any age group on the reservation. The first birth and death rates of infants from the Yakama Reservation were recorded in 1914 when an infant mortality rate could be calculated. Thus, although data on deaths exist from 1888, the central focus of this work will be that fifty-year period between 1914 and 1964. The Yakama Treaty of 1855 and its ratification by the Senate in 1859 set into motion a series of events and circumstances that undermined the health of the Yakama people. As a result of the treaty, the various people placed on the Yakama Reservation secured a small portion of their traditional homelands in central
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