From pandemic response to portable population health: A formative evaluation of the Detroit mobile health unit program

PLoS One. 2021 Nov 30;16(11):e0256908. doi: 10.1371/journal.pone.0256908. eCollection 2021.


This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease "hotspots" based on publicly available SARS-CoV-2 testing data and community-level information about social vulnerability. This formative evaluation explores whether our MHU deployment strategy enabled us to reach patients from communities with heightened social vulnerability as intended. From 3/20/20-3/24/21, the Detroit MHU program reached a total of 32,523 people. The proportion of patients who resided in communities with top quartile Centers for Disease Control and Prevention Social Vulnerability Index rankings increased from 25% during location-based "drive-through" SARS-CoV-2 testing (3/20/20-4/13/20) to 27% after pivoting to a mobile platform (4/13/20-to-8/31/20; p = 0.01). The adoption of a data-driven deployment strategy resulted in further improvement; 41% of the patients who sought MHU services from 9/1/20-to-3/24/21 lived in vulnerable communities (Cochrane Armitage test for trend, p<0.001). Since 10/1/21, 1,837 people received social service referrals and, as of 3/15/21, 4,603 were administered at least one dose of COVID-19 vaccine. Our MHU program demonstrates the capacity to provide needed healthcare and social services to difficult-to-reach populations from areas with heightened social vulnerability. This model can be expanded to meet emerging pandemic needs, but it is also uniquely capable of improving health equity by addressing longstanding gaps in primary care and social services in vulnerable communities.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19 Testing
  • Female
  • Geography
  • Health Services
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Mobile Health Units*
  • Pandemics* / prevention & control
  • Public Health*
  • Referral and Consultation
  • SARS-CoV-2 / isolation & purification
  • Social Work

Grants and funding

Funding was supplied by donors and non-profit organizations including United Way for Southeastern Michigan, the Community Foundation of Southeast Michigan/Detroit Medical Center Foundation, the Ralph C. Wilson Foundation, Community Organized Relief Effort (CORE), DTE Energy Foundation, Blue Cross Blue Shield of Michigan, and the Cielo Foundation. Michigan Department of Health and Human Services (MDHHS) also collaborated and contributed funding to support further growth and extension of services. A CDC funded program (1817) with the MDHHS Heart Disease and Stroke Prevention Unit allowed for cardiometabolic risk factor screening. In addition, funding for the PHOENIX program was provided by the Michigan Health Endowment Fund and Delta Dental Michigan.