Inside mobile health clinic efforts to reach more residents, address gaps in care
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To increase the accessibility and affordability of reproductive health care, local health departments are giving the green light to mobile solutions.
In the U.S., an estimated 270 per 100,000 women die from avoidable deaths. Increased access to preventative screenings and exams could help reduce the number of unnecessary deaths, but building new health care facilities and finding providers to staff them is no easy feat. That’s why one county in California is turning to a mobile solution to address accessibility gaps for women’s health services.
In 2022, the San Luis Obispo County Office of Public Health granted $500,000 in American Rescue Plan Act funds to the Community Action Partnership of San Luis Obispo, or CAPSLO, a nonprofit agency dedicated to alleviating poverty. With the funds, CAPSLO purchased a mobile health unit to offer residents in the county reproductive care and services.
The mobile unit aims to fill service gaps for county residents who struggle to obtain routine and preventative care for their reproductive health. A 2023 survey of more than 3,000 residents found that barriers to care included an insufficient number of health providers in their communities, a lack of transportation options to visit health clinics and high medical costs, said Claire Hermann, community health improvement manager at the San Luis Obispo County Public Health Department. Unhoused respondents cited stigma against the homeless population as a barrier to seeking care.
The vehicle is equipped to offer resources and services, including contraception, breast exams, Pap smears and STI tests and treatment, among others. The van will be staffed with two medical assistants and a medical provider, the San Luis Obispo Tribune reported.
The mobile unit launched in March, and while it’s still a relatively new service to the county, it has not seen a massive uptick in visitors just yet, said Kayla Willburn, clinic director of CAPSLO. About four to six patients seek care at the unit each day, the Santa Maria Sun reported.
Willburn said many patients are unhoused individuals, and Hermann said the mobile unit has mostly visited areas near homeless shelters, homeless encampments or affordable housing units.
“We’re learning how to balance the need for confidentiality and privacy with being in public places,” Willburn said. CAPSLO is working with local libraries to establish agreements for the van to operate in their parking lots, and the organization hopes to eventually operate at high schools too.
Across the U.S., an estimated 3,000 mobile health units are in operation and have seen 10 million visits annually. The vehicles can cost at least $400,000 to $500,000 and require ongoing costs to pay staff, to park and charge the vehicle, to replenish supplies and equipment and to cover other tasks, said Elizabeth Jones, senior director of service delivery improvement at the National Family Planning and Reproductive Health Association.
But offering preventative care to people who wouldn’t have access to it otherwise is invaluable, she said.
“We know that preventative care saves dollars in the long term, but the [health care] system we work in isn’t set up to place priority on prevention, especially preventative care for women and people with uteruses,” Jones explained.
A July report from the Commonwealth Fund, for instance, found that a lack of access to secondary health screenings contributed to high rates of breast and cervical cancer deaths among women.
Mobile clinics can also help “build trust in a profession where there is mistrust, particularly [with] reproductive health,” Jones said.
For residents where reproductive care and services like birth control are being restricted, for instance, traveling health vehicles are particularly helpful, she added. Someone in a state that prohibits abortion could be scared just to get a pregnancy test out of fear of a positive result showing up on their health record. But a parked mobile health clinic on the border of two states with opposing policies offers a solution for people in need, Jones said.
Earlier this year Cleveland deployed the first of two mobile units offering reproductive care services, including HIV and STI screenings, pregnancy tests, contraception and other family planning and counseling resources. The Cleveland Department of Public Health allocated $1.1 million in ARPA funds to purchase and retrofit the vehicles with medical equipment and pay staff.
And in Iowa, the Linn County Board of Supervisors approved ARPA funding for a mobile health clinic that launched in July. It offers services like testing for sexually transmitted infection and vaccinations.
The next steps for health leaders are to consider sustainable funding sources for mobile health clinics, as COVID-era funding like ARPA dollars — which helped catapult efforts to improve community outreach and improvement efforts — dry up, Jones said.
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