The University of Michigan will embed pharmacists in at least five tribal health clinics in Michigan, where they will work alongside physicians and clinic staff and engage in education and outreach.
As part of the College of Pharmacy’s Collaborative for Indigenous Resources in Care, Learning and Equity, the pharmacists will get to know and care for locals and their health and medication needs.
The tribal health clinic collaborative is built on three years of engagement with Michigan’s American Indian and Alaska Native communities by Nicholas Cushman, an adjunct clinical instructor, and Emily Mackler, clinical pharmacist and adjunct clinical associate professor of pharmacy.
Their work led to the creation of the program.
As a member of the Sault Ste. Marie Tribe of Chippewa Indians, Cushman is aware of the cultures and customs that shape health and behaviors — and the equity gaps that worsen health for a community affected by more chronic illnesses and shorter life spans than the general population.
“I’ve seen the strength and resilience of our communities in the face of health care challenges,” said Cushman, who has become a leader on matters of tribal health, including substance use disorder and mental illness.
He also is a commissioned health officer with the U.S. Public Health Service and well positioned to guide pharmacists’ interventions that can treat and prevent illness.
“By partnering with tribal nations, including my own, and my alma mater, we’re building on our cultural values and traditions to implement health care solutions that empower our people and support the prosperity of future generations,” Cushman said.
Michigan is home to more than 240,000 American Indian and Alaska Native residents and 12 federally recognized tribal nations, which are their own sovereign, self-governing entities. As a whole, they experience a disproportionate burden of many chronic conditions, including being three times more likely to be diagnosed with diabetes and twice as likely to die due to complications from the disease compared to the non-Hispanic white population.
“We will be able to leverage the success of integrated pharmacist care for a patient population who has not been part of these programs before and most importantly be able to flex our prior experiences and resources to really meet the priorities of the tribal health clinics and communities,” Mackler said.
Each community has a tribal health clinic that provides basic health care services, including primary and dental care, to both adults and children. For specialized medical needs, patients are generally referred to nontribal facilities across the state.
The program pharmacists in tribal clinics in cities such as Grand Rapids and Fulton are part of an ongoing, broader collaboration between Michigan’s tribal communities and the College of Pharmacy under the leadership of Amy Thompson, clinical professor of pharmacy and director of Community Health and Engagement, and Antoinette Coe, assistant professor of pharmacy.
“Our aim is to empower American Indian and Alaska Native communities and advance culturally relevant health care solutions,” Coe said.
In addition to their role as health care providers, Thompson said, the plan is for pharmacists to facilitate regular meetings among tribal pharmacists, tailor clinical education programs, participate in community events and enhance student engagement.
“We are committed to advancing a multidisciplinary approach to health care by working with other university schools and programs, with an emphasis on meeting the distinct health care needs of each tribal community,” Thompson said.
