The municipal wagon was one of three driven by General Brigham. Originally launched during the pandemic to offer COVID-19 testing in hard-hit neighborhoods like Chelsea, Everett and River, the vans have recently expanded their services to address other health disparities.
The MGH vans are part of a growing movement of mobile clinics in Greater Boston that have attracted increased funding as the pandemic has highlighted existing barriers to health care and created new ones.
Molly Williams, executive director of the Mobile Health Map, a database of mobile clinics in the US, said she has seen tremendous growth in mobile health over the past two years.
“We’ve seen so many new clinics pop up during the pandemic … turning their services and approach in a new way,” said Williams, who is also a lecturer in global health and social medicine at Harvard Medical School.
Several organizations launched mobile clinics during the pandemic to increase vaccine access and address vaccine hesitancy, particularly in underserved communities. Bringing health care directly to patients not only removes the barriers of transportation and time, but helps patients trust their providers, according to Williams, who also serves as executive director of The Family Van, which is operated by Harvard Medical School.
“Our customers tell us because you come to our neighborhood, we know you really care about us,” she said. “It demonstrates a commitment to the community.”
For Manuel Barahona, walking down the street to visit the van is a much more convenient option than crossing the city to Boston Medical Center, where he usually goes for medical care. Barahona, who lives within walking distance of the van’s location in Chelsea, first visited the site out of curiosity after seeing crowds gathering and returned for various health services, including his flu shot last Friday.
Van is not only geographically accessible to Barahona, but also linguistically accessible. A Spanish speaker, he can receive care from the team, whose members speak both Spanish and Portuguese.
Cesar Guerra Castillo, who directs operations for one of the vans, said they choose sites close to established community organizations, such as La Colaborativa in Chelsea or the STEPRox Recovery Support Center, a Roxbury-based organization that offers support for alcohol addiction and/or substances, for patient convenience and also to establish trust.
Since adding the new service a few months ago, the vans have performed 1,256 blood pressure screenings on a diverse population of patients, nearly half of whom identify as Hispanic and nearly a fifth as black, according to Dr. Priya Sarin Gupta, the program’s medical director and a primary care physician at Massachusetts General Hospital and Harvard Medical School. More than a third of patients have high blood pressure.
“Not everyone realizes the importance of knowing what your blood pressure is [or testing for cardiovascular diseases] because they are quiet conditions until they become problematic,” Sarin Gupta said. “This gives us the opportunity to offer health education about what is almost as important as the clinical care we provide.”
On board each van is a team of community health workers and a nurse practitioner, regularly joined by doctors and an addiction recovery coach who are available to answer general medical questions or direct patients to the right resources. Patients can also come with non-medical issues, including food insecurity and housing issues, to connect with organizations that can help.
“I think getting all your information from one person is easier and less confusing than having to Google and try to figure out what you’re eligible for,” said Carla Chamorro Garcia, one of the health workers on the van.
Geographic barriers can prevent many people from getting help because they may live too far from health care providers, said Heidi DiRoberto, regional executive director of Spectrum Health Systems, Inc. A substance use and mental health treatment nonprofit in Worcester, it launched its own mobile treatment service last month, the first in the state to offer all three opioid use disorder medications: methadone, Suboxone and Vivitrol .
The new program, sponsored by the Massachusetts Bureau of Substance Abuse Services, aims to make treatment more accessible to patients struggling with substance use, many of whom must come in daily for treatment.
“With opiate use disorders, particularly methadone, taking medication every day is critical,” DiRoberto said. “But some of these people are homeless or face other inequities that prevent them from attending the program every day … so we bring the treatment to where they are.”
Part of addressing substance use disorders holistically is offering mental health services, which in the post-Covid world can be difficult to access due to high demand. To help fill that gap, Whittier Street Health Center in Roxbury, which has operated its Mobile Health Van program since 2018, announced last week that it will expand its services to include mental health screenings at your four vans.
“This helps identify people who use substances or have mental health disorders early and then help them and their families access resources,” said Frederica Williams, president and CEO of Whittier Street Health Center. “By screening early, before it becomes a major problem, or screening people when they’re ready to commit, we’re able to link them to care.”
The privacy of the van can also help people feel more comfortable sharing their mental health issues, which can carry a lot of stigma, she said.
These programs are part of a long history of mobile care in Greater Boston.
The Harvard Medical School Family Van has operated in the city for the past three decades. Originally started to address the high rates of infant and maternal mortality among Boston’s black population, it now primarily offers chronic disease support to patients four days a week.
“There are a lot of doctors in Boston. What we need is to connect those who need health care with the people who can provide it, and community health workers are really well placed to do that because they come from the community and understand the barriers.” , Williams said.
Zeina Mohammed can be reached at [email protected] Follow her on Twitter @_ZeinaMohammed.