In Wisconsin, Native Americans suffer from sharp health disparities, including higher rates of heart disease, cancer mortality and death and hospitalization from diabetes than the collective Wisconsin population.
There’s an acute need for more health care professionals to staff tribal clinics and provide culturally competent care, a recent report from the Association of American Medical Colleges and the Association of American Indian Physicians said. But it found American Indian and Alaska Natives were “vastly underrepresented in American medical schools.”
For Danielle Yancey, that report is a call to action. Yancey is the first full-time director for the Native American Center for Health Professions, located within the School of Medicine and Public Health at the University of Wisconsin-Madison.
NACHP, formed in 2012, works to improve the health and well-being of Native communities and increase the Native American health professional workforce. NACHP recruits and retains students who seek a UW-Madison medical degree, or are part of the physician assistant, physical therapy, genetic counseling, pharmacy, nursing, social work or veterinary medicine programs.
Once on campus, NACHP builds relationships with Native students to find out what they need to succeed, and provides “everything ranging from cultural programming, community building, mentorship and professional development opportunities,” Yancey said. NACHP even hosts informal “family dinners” to give students a taste of home.
“We have our own unique sense of humor and just way of interacting with each other. That cultural nuance that feels familiar and familial, those are things that for any person just helps to fill you up and re-energize you and helps buffer everything else that you're experiencing,” Yancey said.
Yancey was born on the Menominee Reservation in the northeast corner of the state, came to UW-Madison for her bachelor’s degree and went on to earn a master’s in urban planning and development, as well as a graduate certificate in sustainability leadership. She’s worked for UW-Madison’s PEOPLE program and as a tribal liaison for the Wisconsin Department of Transportation.
Tell me what drew you to your current role.
I grew up on the Menominee Indian reservation. Growing up in a tribal community, making that leap from my home community to UW-Madison as a student was a really big shift. So that was very informative for me throughout my career: to support Native students, to be a connector between our academic institutions and our communities to support our students. When this opportunity came about, I had already been working with NACHP as a career-pathways coordinator at UW-Health, so it was really just kind of a great transition for me to continue that type of work in the health care industry.
When you first came to UW-Madison as a student, what were some of the biggest adjustments?
Well, it definitely was a culture shock. You leave your reservation home community where the majority of people and students you’re around are also Native American and also part of your tribe, and then you come to a predominantly white institution. Being able to find community here was definitely one of the biggest challenges. And the other was often being misunderstood, or interacting with students, or even staff and faculty, that didn’t know a lot about your community or culture. So a lot of my early years was spent sharing more about who we are as Native people and trying to bridge that cultural gap.
In 2017, NACHP said that since it was founded in 2012, it saw a “250 percent increase in the number of Native American medical school applicants.” What do you think is making NACHP work?
One aspect I think that’s really been driving applications to our med school is students are learning that NACHP exists. What we often hear from applicants is that they’re looking for a school that’s going to be supportive of them while they’re pursuing their medical education. … We see that many of them sought our medical school because we have the center, we have staff, we have additional learning opportunities, particularly for students that know they want to practice or have some type of integration with tribal health.
We work with tribal clinics across the state and have opportunities for students to do rotations at a tribal community. We also are able to sponsor students to participate in professional development opportunities that focus specifically on tribal health.
You work with kids as young as middle school, right? When talking with people who might potentially be interested in a medical profession, what are some common concerns they have or barriers they bring up?
I think our biggest goal in reaching young students as early as middle school is just creating a greater awareness and visibility about these career options. For me personally, growing up in a tribal community and having gone to our tribal clinic, you don’t see a lot of Native health professionals.
One of the programs that our center has that was created by Dr. Erik Brodt is We Are Healers, a digital mentoring program that features the stories of Native health professionals and these short video vignettes. When we visit communities we will show these videos where students can see themselves reflected in these careers. These individuals are sharing a part of their story, their background, and what were some of their challenges in deciding to pursue this pathway. It starts a conversation around, these are options that are out there and to know that our center exists and is a resource and support to walk with you in this journey.
NACHP also wants to help address health disparities. How do you do that?
That’s a really big question and there are so many different strategies and ways to do that. Now that our center does have a full-time director, I think that’s increased our capacity … (and) ability to connect with other units within the medical school.
One example is in the Oneida Nation community. The med school’s Alzheimer’s Disease Research Center has a project with the Oneida Nation around early Alzheimer's detection and then (is) working with the elder coalition within the Oneida community to collaborate around culturally appropriate approaches to having conversations around Alzheimer's. Our center has been a liaison on that project and we also have a secondary office in the Oneida community. Being physically present in the community has been huge, so that we can help facilitate and make those connections so tribes can be part of these initiatives if they choose.
And then for all health professional students that are going through their training programs, we’ve been partnering with many of the educators within our med school to invite speakers and health professionals who are working in tribal health or with Native patient populations, so that we can ensure that future practitioners will have some exposure and awareness of serving all populations. I think not undervaluing just the sheer benefit of education towards addressing health inequities is something we’ve been big advocates of.
We’ve also served as kind of consultants for researchers within our school based on their research projects: how to appropriately engage tribes to seek their interest in wanting to participate in this and then following the community’s lead on how they want to be involved.