Armed with her MSU master’s degree in public health and more than 25 years of experience, Noel Pingatore, Spartan in Public Health, joined the fight against COVID-19 to decrease transmission and improve patient outcomes for tribal communities in Michigan. Tribal communities were experiencing higher rates of underlying risk factors for COVID-19 and disproportionate health outcomes.

The Centers for Disease Control and Prevention released a study that found COVID-19 disproportionately affects American Indians and Alaska Natives; in 23 states, the overall incidence of COVID-19 cases among these groups was 3.5 times that of non-Hispanic white Americans. 

Pingatore and her colleagues were prepared to help when the Inter-Tribal Council (ITC) of Michigan received a request for assistance from one of its tribal chairmen.

“All of our departments came together and formed a COVID task force—the Department of Maternal and Child Health, the Department of Environmental Health, and my department,” said Pingatore, who serves as director of the Health Education and Chronic Disease Department.

ITC was incorporated as a nonprofit organization in 1968 by the four original tribes in the state. Today, it represents all twelve federally recognized tribes in Michigan.

“Because we had already established excellent communication channels with community members, we were able to quickly get a lot of credible, reliable information out to the community—how to use PPE, social distancing, testing, contact tracing, watching for symptoms, how to isolate or quarantine,” Pingatore said. “We already had those platforms established and had such a huge following; we were able to reach the community members that way when we couldn’t reach them in person.”

The tribes also operate ambulatory care clinics, Pingatore explained. Through research, she found examples of COVID protocol from other ambulatory care clinics across the nation and adapted them for the tribal clinics. The task force developed key recommendations and shared them via online meetings. “We walked through the recommendations with clinic staff at that particular tribe, and they would come up with their protocol and algorithms for screening and testing patients,” Pingatore added.

Last April, when Michigan’s Governor Gretchen Whitmer signed an executive order to create the Michigan Coronavirus Task Force on Racial Disparities, Renee Branch Canady, another Spartan in Public Health and chief executive officer of the Michigan Public Health Institute (MPHI), was appointed as a task force member.

MPHI had begun partnering with ITC about 20 years earlier, so it was a natural course of action that Canady would reach out to this partnership agency for assistance. Pingatore and her ITC colleagues were able to provide the needed data and information to the task force.

“[Working for ITC] I saw first-hand the many health disparities of the tribal population in the state,” Pingatore said.

“Getting population-level data for small groups is a challenge. We at ITC, with our broad team of expertise, have perfected that,” she added, citing their Tribal Behavioral Risk Factor Surveillance Survey.

During her past 20 years as a department director, Pingatore has provided leadership related to cancer, cardiovascular disease, physical activity, nutrition, and tobacco use at the tribal, state, and national levels. She has been responsible for conducting community health assessments, developing interventions, providing training, and acquiring funding from private, state, and federal agencies.

Pingatore earned her master of public health degree from MSU in 2020.

“I intentionally took one class at a time,” she said. “It allowed me to enjoy the journey, to absorb more of what I was learning. I was able to create an independent study to meet my unique learning needs, and I was encouraged to publish some of the work that we’ve done that better describes the Indian Health Services system.” The paper she wrote under her independent study was published in the Journal of Community Engagement and Scholarship. 

Pingatore is currently working on a paper on the Tribal Behavioral Risk Factor Surveillance Survey that emphasizes community-based participatory approaches and yields a higher response rate. The second paper in progress is about research recruitment methods and strategies. “It can typically be difficult to recruit study participants from tribal communities, but it looks like we’ve found some useful strategies,” Pingatore said.

The ITC has developed a website to provide resources, training, and technical assistance in response to COVID-19. To access the site, go to https://www.itcmi.org/covid-19-resources/.