Pharmacy graduate brings health care home to underserved rural Washington

Rural can look different from town to town. That can be said not just for the scenery and local cuisine but also for the health care challenges people face.

Perhaps no one knows this better than Catalina Yepez, a lifetime resident of Prosser, a town of roughly 6,000 people in Central Washington where she grew up acting as translator for her family at medical appointments. In her largely Spanish-speaking agricultural community, seeking medical care often comes as a last resort.

"Unless something is seriously wrong, people hesitate to go to the doctor," said Yepez. "That delay can turn a manageable condition into something life-threatening."

Yepez, now 32 and a mother of a four-year-oldson, is stepping up to change that. At the end of June, she'll begin a pharmacy residency at the Yakima Valley Farm Workers Clinic in Toppenish, Washington. One of the first five graduates of the Washington State University College of Pharmacy and Pharmaceutical Science's Rural Health Initiative, Yepez aims to improve health outcomes by building trust, especially among Hispanic men who she found in her research often go untreated for conditions like high blood pressure.

"During my residency, I want to focus on building relationships and consistent follow-upsso that checking your blood pressure or getting a physical becomes routine," said Yepez, who spent the last few years commuting more than 45 minutes every day from her home in Prosser to take classes at WSU's pharmacy program in Yakima. "It's about education, yes - but it's also about trust."

If you don't have access to a pharmacist, you often don't get care. Pharmacy deserts typically have higher rates of uncontrolled chronic disease and lower life expectancy.

In rural areas like Prosser and Toppenish, pharmacists often serve as frontline providers. More than 800,000 people in Washington live in areas lacking adequate access to health professionals, and over 450,000 reside in designated pharmacy deserts - low-income regions where the nearest pharmacy may be more than 10 miles away. This can lead to poor health outcomes. For instance, in her research Yepez found that men were three times more likely to have high blood pressure when they did not have a medical provider.

"If you don't have access to a pharmacist, you often don't get care," said Julie Akers, a professor of pharmacy at WSU who helps lead the Rural Health Initiative. "Pharmacy deserts typically have higher rates of uncontrolled chronic disease and lower life expectancy."

That growing need is exactly what the initiative set out to address when it launched three years ago, thanks to an anonymous $2.2 million gift and the vision of the college's Dean Mark Leid. The program recruits students from rural backgrounds and provides up to $10,000 in annual scholarships if they spend three years working in rural areas after graduation. It also provides specialized training and helps place graduates in underserved communities where they can do much more than dispense medication.

During her residency at the Yakima Valley Farm Workers Clinic in Toppenish, Yepez will be able to treat minor ailments like coughs, allergies, rashes, and backaches, and evaluate and manage medication therapy for chronic diseases like hypertension and diabetes. Rural pharmacists-who often know their patients by name-are also particularly well-positioned to catch emerging health problems early and refer patients to physicians when needed.

"Our pharmacists don't just fill prescriptions," said Marc Murdock, clinical pharmacy director at Yakima Valley Farm Workers. "They manage care plans, monitor labs, and keep in close contact with patients. The more touchpoints we have, the better the outcomes."

Murdock added that rural pharmacists often develop strong relationships with their communities. "They could go elsewhere and maybe make more money, but they choose to make their impact here," he said. "That makes all the difference."

For Yepez, the decision to stay in the area was never in doubt.

She's lived the barriers her patients face - lack of transportation, long commutes, and language obstacles - and sees how much relief it brings when patients hear Spanish at the pharmacy counter.

"Sometimes they struggle in English, and when I speak Spanish, their whole face relaxes," she said. "They can finally tell me exactly what's wrong."

One of Yepez's goals is to use data she gathered as part of the Rural Health Initiative to develop a community health effort focused on reducing hypertension among Hispanic men. That means not just education, but follow-upand consistency - building the kind of rapport that changes habits over time.

"I want to make health care feel familiar, accessible - something that belongs to everyone, not something you wait for until you're in crisis," she said.