In Canada, marginalized populations face many barriers to accessing the health care they need, which can lead to poor outcomes.
Researchers at UHN's Toronto General Hospital Research Institute (TGHRI) and the UHN Social Medicine program have demonstrated that mobile health clinics (MHCs) — providing primary care, harm reduction and mental health services at convenient locations within a community — can alleviate these barriers to care.
Despite Canada's universal health care system, socioeconomic factors still contribute to disparities in health outcomes. As a solution to this inequity, MHCs have been deployed in cities across the country.
These clinics are designed to be present in convenient locations within communities while offering a wide range of services, including prevention, primary care, support with income assistance applications, harm reduction and mental health services.
MHCs provide care to clients who are poorly served by the traditional health care system due to financial, geographic, or cultural barriers, as well as previous negative experiences in health care settings. However, little is known about the impact of MHCs in countries with universal health care such as Canada and the characteristics of the clients they serve.
In 2021, Parkdale Queen West Community Health Centre, TELUS Health for Good and UHN's Gattuso Centre for Social Medicine partnered to launch a nurse practitioner-led, community-based MHC in Toronto.
The MHC serves approximately nine locations in downtown Toronto including shelters, community centres, high-density buildings and encampments.
To better understand the impact of MHCs on the community, the research team surveyed and conducted interviews with clients after they had received care.
Most clients — 61 per cent — reported being homeless and 37 per cent said that without the MHC they would have accessed care at an Emergency Department, while 18 per cent would not have sought care at all, according to the study by senior author Dr. Andrew Boozary, a clinician-investigator at TGHRI, Executive Director of the Social Medicine and Population Health Program at UHN, and assistant professor at the Dalla Lana School of Public Health at the University of Toronto, and first author Meghan O'Neill, former epidemiologist and evaluation specialist for the Population Health Analytics Lab and a research officer with the Dalla Lana School of Public Health.
The team also identified factors that improved care experiences and access: client-centred approaches to communication; inclusive environments; reducing barriers such as cost and transportation issues; and connecting clients to other health and social services within the community.
This work highlights how MHCs help deliver care to those who face challenges accessing health care and can help inform the best ways to reach underserved communities.
Although MHCs are often thought of as an alternative form of health care, these findings indicate that MHCs serve as an entry point to and a connection with the health care system.
This work was supported by the Gattuso Centre for Social Medicine at UHN and UHN Foundation.
