An analysis of mobile health clinics launched in the Detroit metro area during the pandemic finds it's a model that can deliver health screenings and health care and could be replicated in other communities.
The Wayne Health Mobile Units are specially equipped vans with medical equipment and professionals. They began as testing sites for front-line workers in the early days of COVID-19, out of a partnership between Wayne State University and Ford Motor Co. Over time, they transitioned to what Dr. Phillip Levy, a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne state and chief innovation officer for Wayne State University Physician Group, called a "vision of patient-centric, portable population health."
"If they have comorbidities and need doctors' appointments or health care," said Levy, who runs the program, "can we provide linkages around that? If they have food insecurity, can we help them get food access, so that we can really be delivering on the holistic approaches that are needed in order to keep this person healthy and avoid complications?"
Levy noted they have a Patient Portal for folks to register online, but appointments are not necessary, and they don't require insurance or identification - which can be barriers to care. He added that bringing care into communities also reduces the barriers of transportation time and cost.
Beyond testing and treatment for COVID, Levy said the Mobile Health Units do blood screenings for high cholesterol, diabetes and kidney disease and provide prevention infrastructure - as well as blood pressure screenings for hypertension. He said they also are building out HIV screening and treatment, and have started working with the state's needle-exchange program.
"Can we use these vehicles to reach vulnerable communities of IV drug users," he said, "not to distribute needles alone, but to test for HIV and hepatitis C and B, and provide medical linkages to care?"
Levy pointed out that 40% to 50% of the people who visit the Mobile Health Units come from areas where the social vulnerability index is extremely high. For other communities looking to replicate the program, he said building trust over time is important, and can be done with the help of faith groups and community-based organizations.
"Communities know that when the Wayne Health vans come, they're not coming for one time, they're going to be there, maybe for several days in a row," he said. "But we're going to be back over and over again, providing these resources to community members."
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Groups across the state are working to reduce overdose deaths among minority populations.
According to state data, overdose deaths are on the decline but among Black residents, there were around 68 deaths per 100,000 people last year; more than 51% greater than the overall rate of deaths.
Matt Johnson, board member of the nonprofit CARES Coalition in Franklin County, said the county is struggling with a lack of emergency shelter and medical services for undocumented individuals. The coalition's Community Connectors Project aims to go door-to-door in neighborhoods to help residents access the services they need.
"People who don't necessarily have a visa or a green card, or even health insurance," Johnson outlined. "We need them to be able to go and receive services; for kids to be able to see dentists, especially within our minority population has been a challenge."
The coalition is one of 10 organizations awarded $50,000 grants from the Foundation for a Healthy Kentucky's Funding for Recovery Equity and Expansion program, a partnership with the Cabinet for Health and Family Services' Kentucky Overdose Response Effort.
In Western Kentucky, the Four Rivers Foundation has expanded mental health and health care services in underserved schools.
Dr. Alex Wright, CEO of Wright Medical who works with the foundation, said gaps in access often result in students either not receiving or experiencing long delays in care. He noted so far, more than 3,000 students have been served in the classroom.
"In some of our districts, we estimated up to 50% of children were lacking any continuity of health care," Wright reported. "Many of these children haven't had a pediatrician or primary care provider, usually since they were an infant or a toddler."
Research points to increased stigma surrounding substance use disorder and mental health in communities of color. According to the Yale School of Medicine, treatment inequities persist. Nationwide in 2018, the majority of Black and Hispanic people diagnosed with the substance use disorder did not receive treatment.
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By Cat Sandoval for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration
Respiratory syncytial virus (RSV) is on the rise in Indiana, according to the Centers for Disease Control and Prevention, and it's forcing some hospitals to implement visitor restrictions.
Dr. Christopher Doehring, of Franciscan Health in Indianapolis, spoke with News 8 about why this respiratory virus increases during winter months and what hospitals are doing to prevent its spread.
"Like most of the respiratory viruses, as the weather turns cooler and people spend more time inside and around each other, its a just a highly contagious respiratory virus," Doehring said. "Like all respiratory viruses, we tend to see an increase in cases this time of year."
Holiday get-togethers can help spread the virus.
"You start to see around Thanksgiving time, you start having families coming together," Doehring said. "They're spending times in doors and it's multiple generations together. It's a natural epidemiologic phenomenon."
According to medical experts, RSV causes infections in the lungs. In healthy adults and older children, symptoms are mild, similar to the common cold.
RSV can be prevented by using good hygiene, such as washing hands and avoiding touching one's face.
Doehring said babies, premature babies, and immunocompromised elderly adults can experience severe cough, shortness of breath, and pneumonia, or even death. Doehring recommends getting vaccinated.
"Once you have the symptoms or are under the weather, take the time to recover, heal, and minimize exposing others as best as you can," Doehring said.
At Franciscan Health Hospital, masks and hand sanitizers stations are readily available to prevent the spread. Those under the age of 18 because younger visitors are more likely to spread respiratory viruses. Other hospitals in Marion County are doing the same.
Doehring says he has seen an increase of RSV cases, which is typical this time of year, but it's not alarming.
"Certainly in our hospitals and around other hospitals in central Indiana, we're not at a point where we're overrun or overcrowded in our ICUs or emergency department," Doehring said.
Cat Sandoval wrote this article for WISH-TV.
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A coalition of Montana groups will rally at the Capitol Wednesday to advocate for the protection of Medicaid expansion, which legislators will debate this session before the program's scheduled expiration in June.
The state's 10-year-old Medicaid expansion program covers 75,000 low-income Montanans at an annual cost of about $1 billion, according to KFF Health News. The state picks up about 10% of the tab.
Kristen Stewart of Billings is a caregiver for her 90-year-old grandmother, and enrolled in Medicaid herself. As an organizer with the advocacy group Big Sky 55+, she noted many Medicaid enrollees work but the work is often undervalued.
"Medicaid supports a lot of people who are doing unpaid work," Stewart pointed out. "Things that were we to monetize, you would see an economic boost from their production level, often more than the cost of their care."
The Gianforte administration already tightened eligibility for the program, cutting the number of enrollees by nearly 40% between May 2023 and October 2024. The program currently covers nondisabled adults ages 19 to 64 who make less than $21,000 a year.
Jeannie Brown, a bus driver for the Belgrade Public School District and a full-time caregiver and legal guardian for her teenage granddaughter, said if Medicaid expansion does not get reauthorized, she will be on a "slippery slope."
"Because I'm 60 years old and I'm having my own health issues after being a caregiver, it's hard work and it takes a toll on you physically, financially and emotionally," Brown explained. "I'm hoping these legislators really take all of these things into consideration and reauthorize it."
Any laws passed on the issue could also affect the state's behavioral health services, which Gov. Greg Gianforte has made a priority.
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