By 9:30 a.m. on a recent Friday morning, a line of people stretched for more than a block under the Adamski Memorial Highway in Chelsea.
They were waiting for a bi-weekly food pantry program run by La Colaboratíva, a local organization focused on empowering Latino immigrants. But some stayed longer to visit a blue van parked next to the heaps of produce and canned goods.
Inside, visitors could receive free COVID or flu shots, have their blood pressure checked, get a referral for programs that treat substance use disorders and receive health information in nearly a dozen languages.
The Community Care Van is one of three operated by Mass General Brigham. Originally launched during the pandemic to offer COVID-19 testing in hard-hit neighborhoods like Chelsea, Everett, and Revere, the vans recently expanded their services to tackle other health disparities.
The MGB vans are part of a growing movement of mobile clinics in Greater Boston that have attracted increased funding as the pandemic highlighted existing barriers to health care and created new ones.
Mollie Williams, executive director of the Mobile Health Map, a database of mobile clinics in the US, said she’s seen tremendous growth in mobile health care over the past two years.
“We’ve seen so many new clinics come up during the pandemic ... pivoting their services and approach in a new way,” said Williams, who is also a lecturer on 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, especially in underserved communities. Bringing health care directly to patients not only eliminates barriers related to 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 clients say to us, ‘because you come to our neighborhood, we know that you really care about us,’” she said. “It demonstrates commitment to the community.”
For Manuel Barahona, walking down the street to visit the van is a much more convenient option than crossing town to Boston Medical Center, where he usually goes for medical care. Barahona, who lives walking distance to the van’s Chelsea location, first visited the site out of curiosity after seeing crowds gather and has returned for different health services, including his flu shot last Friday.
Not only is the van geographically accessible to Barahona, but also linguistically accessible. A Spanish speaker, he is able to receive care from the team whose members speak both Spanish and Portuguese.
Cesar Guerra Castillo, who oversees operations for one of the vans said they choose sites close to established community organizations, like La Colaborativa in Chelsea or STEPRox Recovery Support Center, a Roxbury-based organization offering alcohol and/or substance addiction support, for the convenience of patients and also to establish trust.
Since adding the new service a few months ago, the vans have completed 1,256 blood pressure screenings to a diverse population of patients, almost half of whom identified 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 presented with high blood pressure.
“Not everyone realizes there’s an importance to knowing what your blood pressure is [or testing for cardiovascular diseases] because they’re silent conditions until they’re problematic,” said Sarin Gupta. “It gives us an opportunity to offer health education about that which is almost as important as the clinical care we provide.”
Aboard each van is a team of community health workers and a nurse practitioner, routinely joined by physicians and an addiction care recovery coach, available to answer general medical questions or refer patients to the right resources. Patients can also come in with non-medical concerns, including food insecurity and housing issues, to be connected with organizations that can help.
“I think getting all your information from one person is easier and less intimidating than having to Google and try to understand what you’re eligible for yourself,” said Karla Chamorro Garcia, one of the van’s community health workers.
Geographic barriers can stop many people from getting help because they may live too far from health care providers, said Heidi DiRoberto, Regional Executive Director at Spectrum Health Systems, Inc. A nonprofit substance use and mental health treatment provider in Worcester, it launched its own mobile treatment service last month, which is the first in the state to offer all three medications for opioid use disorder: methadone, suboxone and vivitrol.
The new program, sponsored by the Massachusetts Bureau of Substance Addiction Services, aims to make treatment more accessible to patients struggling with substance use, many of whom need to come in daily for treatment.
“With opioid use disorders, specifically methadone, getting medicated every day is critical,” DiRoberto said. “But some of these folks are homeless or face other inequities that don’t enable them to come to the program every day ... so we’re bringing the treatment to where they are.”
Part of holistically addressing substance use disorders is offering mental health services, which in a post-COVID world can be difficult to get access to because of high demand. To help fill this gap, the Whittier Street Health Center in Roxbury, which has operated its Mobile Health Van program since 2018, announced last week that it would expand its services to include mental health screenings to its four vans.
“This helps to identify people that have substance use or mental health disorders early and then help them and their families to access resources,” said Frederica Williams, President & CEO Whittier Street Health Center. “By screening early before it becomes a major issue or screening people when they are ready to engage, we’re able to connect them to care.”
The privacy of a van can also help people feel more comfortable sharing their mental health struggles, which can carry a lot of stigma, she said.
These programs are part of a long history of mobile care in Greater Boston.
Harvard Medical School’s The Family Van has operated in the city for the past three decades. Originally started to address high infant and maternal mortality rates in Boston’s Black populations, it now primarily offers chronic disease support to patients four days a week.
“There’s plenty of doctors in Boston. What we need is to connect those who need health care to the people who can provide it and community health workers are really well positioned to do that because they come from the community and understand the barriers,” said Williams.
Zeina Mohammed can be reached at email@example.com. Follow her on Twitter @_ZeinaMohammed.