Tribal Nations Face Unique Healthcare Challenges Based on Circumstances and History

By Krystal Schramm, Director of Native American Engagement & Senior Technical Business Analyst for Michigan Health Information Network (MiHIN) and member of HIMSS Michigan Chapter; and Will Gu, Senior Manager, Enterprise Platforms – Laboratory Integration Services and Wisconsin HIMSS Advocacy Director

November is National Native American Heritage Month in the U.S., providing an opportunity for everyone to recognize the 450,000 million+ Indigenous people around the world whose communities and lands overlap with more than 90 countries and encompass thousands of languages. Some of the oldest Indigenous cultures are tens of thousands of years old.

Tribes are sovereign and independent nations with their own governments that are responsible for their populations, including their public health and the management of their population’s health data in the tribe’s healthcare system.

Wisconsin is home to 11 federally recognized tribes, accounting for approximately 1.2% of the state population. These tribes include the Bad River Band of Lake Superior Chippewa, Ho-Chunk Nation, Lac Courte Oreilles Band of Lake Superior Chippewa, Lac du Flambeau Band of Lake Superior Chippewa, Menominee Tribe of Wisconsin, Oneida Nation, Forest County Potawatomi, Red Cliff Band of Lake Superior Chippewa, St. Croix Chippewa, Sokaogon Chippewa (Mole Lake) and Stockbridge-Munsee.

Each tribe has its own health clinic that offers a variety of specialty services, including primary care, dental care, behavioral health, pharmacy, chiropractic care, podiatry, eye care and more.

These tribes, like many Indigenous communities across the United States, face challenges around healthcare and socioeconomic disparities. Data shows that the health indicators for American Indians in Wisconsin are far worse than the health metrics of other populations in the state. Poverty is much higher, and this is seen in the national average across all tribal populations in the nation, including Wisconsin.

Infant mortality is higher, life expectancy is significantly lower than other populations, and there are many diseases and illnesses that affect Native populations in Wisconsin and around the world, such as diabetes, heart disease and cancer.

Tribal patients move in and out of non-tribal and tribal healthcare facilities, sometimes across state lines, but their health data typically does not follow them.

When tribal patients have referrals out to specialists, patient data is often not connected electronically. Faxing and paper charts are still used for patient care, and the inefficiencies of these modalities contribute to lower care coordination because data is not available at the point of care.

Tribes have historically not been included in health information exchanges. In Wisconsin, only the Menominee Tribe of Wisconsin, Ho-Chunk Nation and Oneida Nation are connected to the Wisconsin Statewide Health Information Network (WISHIN).

Improving sharing of digital health information at the individual patient level and at clinic and system-wide levels through increased interoperability can help reduce patient and provider burden while improving health outcomes.

It's important to note that each tribe faces a unique set of challenges based on their specific circumstances and history. Efforts to address challenges and close gaps in care require close collaboration between tribal governments, federal and state agencies and community organizations to improve the well-being and health of tribal members.

Take Action

Join the HIMSS Native American and Indigenous Peoples Community, for anyone interested in tribal healthcare and health information and technology. This community is committed to educating and equipping tribal leaders and tribal health professionals with culturally informed resources designed to help improve health outcomes and enhance access and opportunities within Native American and Indigenous people’s healthcare. Gather with fellow visionaries and health equity advocates to improve the delivery of care and transform tribal health. 

Deepen your understanding of the Indigenous Peoples of America with resources for children of all grades.

Find Native American exhibits and collections across the country.

Learn more about the Tribal Nations of Wisconsin.

Familiarize yourself on tribal advocacy and supporting their unique needs by learning about the Great Lakes Inter-Tribal Council, Inc., based in Lac Du Flambeau, Wisconsin. GLITC is a consortium of federally recognized tribes in Wisconsin and the Upper Peninsula of Michigan.

All HIMSS members are welcome to join communities and HIMSS Global Health Equity Network, an initiative focused on advancing diversity and inclusion to ensure health and wellness for everyone, everywhere.