A 12-year-old boy had been walking with an unexplained limp for months, but his mother couldn’t get him to a provider, the closest of which was 20 miles away. One day, she came across a big bright truck in her son’s school parking lot with the name Texas Children’s Hospital spanning the length of it. She ventured over tentatively and asked if she could bring her son by. Later that evening, he was in the OR receiving emergency surgery for slipped capital femoral epiphysis, a condition that leads to serious, life-long complications if treatment is delayed.
“By coming to patients where they are, mobile health clinics flip the patient-provider dynamic on its head,” says Elizabeth Wallace, executive director of the Mobile Healthcare Association. “That makes them uniquely situated to improve quality and outcomes.”
Underserved and vulnerable populations—those who lack adequate access to medical care for different reasons, such as race, geographic location, income, insurance, or language—are at a much higher risk of being hospitalized for avoidable health problems and have higher rates of morbidity and mortality. Some estimates say more than 20 million children in the United States lack sufficient access to essential health care, even those who live in urban areas with no shortage of providers.
“Even if you have the most amazing children’s hospital in the world, some people can’t access that care,” says Sanghamitra M. Misra, M.D., MEd, FAAP, medical director of the mobile clinic program at Texas Children’s in Houston. “They may be scared because they don’t have health insurance or confused about how to navigate the system. Or they don’t even know how to begin trying to figure out the logistics of getting there.”
Besides mobile clinics’ obvious solution to transportation barriers, research from the International Journal for Equity in Health cites the informal setting, familiar environment, convenient location and staff who “are easy to talk to” as some reasons vulnerable populations value mobile health care.
Access isn’t the only barrier to care. Patients and families may avoid medical visits due to poor health care experiences or a perceived lack of compassion. More than half of low-income patients believe doctors can’t be trusted, according to a report from Mobile Health Map, a virtual tool from Harvard Medical School. “Trust in the health care system with underserved communities was already low prior to the pandemic,” Wallace says. “Mobile health clinics are designed to become immersed in communities by fostering relationships, not only with patients but with community organizations, and literally meeting people where they are and not dictating health care to them.”
Meeting unmet needs
Mobile health clinics have been providing care for decades, but the pandemic put them in the spotlight when there was a rush to test and immunize the nation against COVID-19. Their adaptability and mobility were an ideal solution, and since then states, community organizations, and hospitals have been increasing investments in them. Mobile Health Map estimates there are more than 2,000 mobile clinics now in the United States—all capable of serving a variety of needs. Those needs vary from community to community and shape the services children’s clinics offer and the populations they serve—whether it be a dental clinic or asthma center, a vision clinic or primary care unit. Some children’s hospitals and health systems offer broad services across a large geography while others focus on a highly specific service in a specific area.
