A Breath of Fresh Air on Chicago’s Far South Side
In Roseland, a far south side neighborhood of Chicago, nearly 30% of the area’s children have asthma. Within three years of launching mobile clinics operated from vans, Mobile Care Chicago serves an estimated 10,000 kids and adults annually and has lowered ER admittances for pediatric asthma by 58%.
Even though asthma is the most prevalent chronic disease in Chicago’s low-income areas, it is an epidemic and it is not taken seriously enough by people who don’t see the day-to-day distress that a respiratory disease can cause.
In Roseland, a far south side neighborhood of Chicago, nearly 30% of the area’s children have asthma. Some years ago, the Roseland community hospital was on verge of closing and there was no one else to serve those kids if the emergency room disappeared. There were no specialists in the neighborhood. This was their reality. For a lot of complicated reasons, there are low-income families unable to access medical care through the traditional health care system. Ninety-nine percent of the kids we serve in Roseland have been to an ER for medical care before coming to us. Over 45% of our dental patients have never been to a dentist.
In 2012, we had an idea – what if we partner directly with an ER and see if we can’t reach those kids who come in for asthma and convince them to receive preventative care aboard our Asthma Van? Mobile Care Chicago now runs mobile clinics – two Asthma Vans and two Dental Vans – that provide medical and dental care to low-income kids in Roseland and other communities in Chicago. We provide specialty care for over 10,000 children per year, and because our mobile clinics are often only blocks from a child’s home, we’re consistently able to reach kids who are falling through the cracks. We are able to change our patient's lives by alleviating chronic pain and discomfort.
Our goal is to reach kids who have the greatest need for medical and dental care, so we focus on chronic conditions like asthma, severe allergies, and tooth decay. There are rarely specialists in low-income neighborhoods, so a lot of kids who need intensive follow up can’t find it and as a result they end up in the ER. The Asthma Van almost exclusively does follow-up care. Our goal is to completely adopt the specialty care of children with asthma and remain their specialist provider until they turn 19 or graduate from high school. We have some patients who have been with us all 16 years that Mobile Care has been in existence.
When we were launching the mobile program, we spoke with a number of funders about our plan without success. We kept bumping into a wall. When other funders said no, the Field Foundation said yes. I know that it took courage for the foundation to get behind us. When I spoke with Cheryl [Heads, Senior Program Officer], she started asking a lot of questions. She wanted to know the nuances of how it would work, how we would install someone in the ER, what metrics were available to track. She was asking exactly the questions we had asked when Mobile Care had drawn up our plan. After our first meeting, I knew that Cheryl was someone who understood the urgent need for our idea. She demonstrated that the Field had the mindset to do this work. As a foundation, they have a common sense perspective and are very supportive.
After we were given our award, it was not an easy roll-out. Cheryl was with us through all the bureaucratic delays and implementation issues. After three years, we proudly reported that Mobile Care Chicago had lowered ER admittances at Roseland Community Hospital for pediatric asthma by 58% – from 633 kids in 2013 to 268 this past year. Important innovations rarely come easy. They take a great deal of work and even some failures. The Field Foundation had enough faith in us to let us do our work, and that trust reaped huge dividends for the kids we were able to reach. And Cheryl has remained a strong advocate for our mission. She encourages us to pursue new projects, and she’s been a consistent source of optimism for us.
For many of our kids, the ER is the very worst place to receive health care. Children with asthma, in over 70% of cases, need to be on daily medications that alleviate the constriction of their airways. An ER will not prescribe daily medications, teach parents how to properly dose the medication, or even diagnose asthma. It’s common to find children who have been to the ER over 20 times in a year for shortness of breath who have pediatricians unaware they have breathing issues. Many kids stop exercising and afterward deal with weight issues. For kids in higher income areas, this lack of appropriate medical care for a potentially fatal disease would be unacceptable. For over 300 kids the message came through loud and clear: you don’t have to live this way. Your life is precious, and you deserve quality medical care that allows you to breathe.
“I've learned that the level of misunderstanding of asthma knowledge and the miscommunication between medical providers and families in the community is substantial and this directly affects the impact of asthma on area kids. The care that Mobile Care provides works to remove those barriers. It is important that we continue this work. Lives literally depend on it.” – Kamari Thompson, Asthma Educator for Mobile Care Chicago
The long-term impact of funding from Field Foundation is important. Mobile Care built an infrastructure inside an ER which hopefully will last for many years to come. The longer we’re able to maintain implementation of our partnership with the ER, the more likely it is that we will reach the children who are repeat users, and the more likely families are to take advantage of our Asthma Van. We have patients who, before joining the Asthma Van, had visited the ER over 20 times in a year. The more often these repeat users see and talk to our staff, the more likely they are to utilize the referral and get the medication and care their child needs. The quality of life in the whole Roseland neighborhood is raised through this intervention.
There aren’t many funders who make it a point to find new, innovative projects and help them launch. But these new programs are absolutely essential to community medicine. No person I know would say the health care system we have is reaching everyone or providing the highest quality care. We need a spirit of curiosity and experimentation, focused on patient outcomes. Field Foundation helps ideas reach implementation. We all benefit from that.