40 Years of Increasing Access to Health Services through Mobile Health in Tucson, AZ
The ability to access high-quality health services impacts an individual’s health throughout all life stages. Several factors can inhibit accessing services, including lack of health insurance, a shortage of health care facilities and primary care doctors, and language or cultural barriers. The consequences of not being able to regularly access health services can be significant.1 For example, easily detectable or preventable conditions are more likely to remain undiagnosed, which can lead to serious illness, increased likelihood of premature death, and decreased quality of life.2
Access to health care is a major problem for Pima County, Arizona, residents living at or below the poverty line. Pima County, Arizona, is located on the U.S.-Mexico border and has over 1 million inhabitants, with half living in Tucson, Arizona. In Pima County, 35.7% of the population is Hispanic/Latino and 4.2% is American Indian, and a majority of its residents live in Health Professional Shortage Areas (a Medically Underserved Area/Population). In 2014, 10% of adults were uninsured and 19% of residents lived in families with incomes below the poverty threshold. According to the Pima County Community Health Needs Assessment, individuals without health insurance are significantly less likely to visit a doctor and take prescribed medicine as directed due to cost. In 2015, the assessment found that the Pima County residents most likely to be uninsured in the past year were Hispanic adults aged 18–34 years and members of low-income households.3
In 1976, the Mobile Health Program was established to empower undeserved communities by developing sustainable systems that increase access to health promotion, disease prevention, and health care services. The program, which is a part of the Banner University Medical Group/College of Medicine Department of Family and Community Medicine at the University of Arizona, offers a wide range of programs and services to those who live in rural and underserved areas of Arizona, including along the U.S.-Mexico border, and are unable to afford and/or access medical care.4 The program targets vulnerable adults and children who reside in Health Professional Shortage Areas, including the uninsured, Spanish-speaking populations, individuals and families who are homeless or at risk for homelessness, the working poor, veterans, seniors, persons with disabilities, and pregnant teens and women.5 In addition, the program informs, educates, and empowers people about health issues; develops policies and procedures that support individual and community health efforts; links people to needed personal health services; and assures the provision of health care when otherwise not available.6
To provide access to care, the Mobile Health Program offers the Mobile Health Clinic (which is a doctor’s office and clinic on wheels), vaccinations, prenatal and birth care to expectant mothers, and diabetes education. Annually, the program provides approximately 2,500 patient services, including physicals, immunizations, well woman checks, pap smears, prenatal and birth care, dental screenings for children, diabetes education, and minor procedures. Patients seen in FY 15 range in age from 0 to 86; 86% were racial and ethnic minorities.7 Each year, the program provides prenatal care to approximately 25–30 pregnant women and dental services to approximately 600 children and expectant mothers.
For many patients in Pima County, the Mobile Health Program is their only health care provider. Through various partnerships, including collaborations with community organizations, the program has been able to provide access to primary medical care, early prenatal care, preventive services, and timely referrals for other medical and psychological services.6 In the coming months, the program plans to expand their reach by opening additional sites and providing services for adolescents, at-risk populations, homeless populations, and the Native American population.
Mobile Health Program
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