Seven Generations Architecture + Engineering has extensive experience in healthcare architecture and in tribal healthcare facilities in particular. From Pokagon Health Services at 35,000 square feet to the Mille Lacs Band of Ojibwe District 1 Health Clinic at 78,000 square feet, our team delivers spaces that can strengthen tribal communities and improve patient experience. We strongly believe that the built environment impacts healthcare, and our work is guided by evidence-based design principles. Inspired by this mission, 7GAE is embarking on a healthcare research journey to explicate the role of culturally reflective architecture on patient outcomes.

Pokagon Band Health and Wellness Cultural Image

Asking the Questions

While there is a lot of evidence-based design research in the field of healthcare architecture, there is little that is specific to Indigenous communities. We know that tribes face unique challenges: among them, a history of healthcare inequity. There are many groups doing wonderful work to address inequality and ensure that Indigenous people across the country have access to quality healthcare. In addition to this work, we believe that architecture and design can play a role in improving patient outcomes. As we begin our research, we have four major assumptions about tribal healthcare architecture that we believe to be true. These assumptions are based on our design experience, years of collaboration and discussion with tribes, and many conversations with medical professionals and community members. Despite this experience, we come from a place of humility as we aim to quantify our beliefs and produce meaningful results that can better inform not just our practice, but the work of all those who contribute to tribal healthcare.

We believe that culturally reflective healthcare spaces achieve the following:

1. Contributes to an overall sense of belonging and connection for Tribal patients.
2. Eliminates some of the many barriers to quality healthcare access by fostering trust through cultural identification.
3. Positively influences the effect of public health campaigns.
4. Can be as cost effective as a universal healthcare design.Mille Lacs Wayfinding

Getting the Answers

To get concrete answers to these questions, we are conducting a two-part research project. The first is a quantitative survey filled with questions that help us better understand how patients visiting tribal healthcare facilities feel about these spaces. Second, we are diving deeper through one-on-one interviews and focus groups that can give us a richer understanding of how people interact with and are influenced by their local healthcare spaces.

After data collection and analysis, Seven Generations Architecture + Engineering will publish our findings so that they are accessible and available to everyone. While what we discover will almost certainly inform our future healthcare design and programming, this is not information we want to keep to ourselves. Our hope is that by beginning this research journey, others will follow suit and continue exploring the many ways that we can improve healthcare outcomes for Indigenous people across the country. Stay tuned for published findings in 2021.

If you are interested in collaborating with 7GAE on this research, please contact If you would like to help us with data collection, consider filling out our anonymous survey. While we are searching specifically for Native American and Alaskan Native respondents, all are welcome to complete the survey or share it over social media to help us increase our scope.



Survey Link: