Embracing autonomy: The impact of socio-cultural and political factors on tribal health care management levels

Abstract

Core notions from social movement research and Sociology of Law studies are integrated into development theory and power/inequality arguments to evaluate the relative importance of internal social organizations of groups, resource dependency, and the impact of the organizational learning process on Native American tribes' inclinations to take greater amounts of control over their economic, political, and social development. This frames development as a political problem, not just an economic one. An analytical model is developed that can be applied to many indigenous groups. This model is used to answer the following question: when new opportunities for sovereign expression are created through changes in the law, which sociological factors impact the ability to take advantage of it? This study raises and addresses some theoretical questions about the conditions under which collectivities opt for more self-determination and develop greater institutional autonomy. It also addresses public policy issues by identifying factors that have proven to be barriers for tribes to pursue greater degrees of self-determination.