Work described in this story was made possible in part by federal funding supported by taxpayers. At Harvard Medical School, the future of efforts like this — done in service to humanity — now hangs in the balance due to the government’s decision to terminate large numbers of federally funded grants and contracts across Harvard University.
A five-year, $1 million grant to Harvard University from the U.S. Centers for Disease Control and Prevention that began in July 2024 was designed to provide support for a sector of the American health care system that can save lives, reduce the rate of serious disease, and lower costs of medical treatment.
In April 2025, before even the first year of funding had been completed, the grant was canceled.
The Harvard Medical School-based Mobile Health Map — the research and education arm of The Family Van — had been awarded the funds to spread the word about the value of mobile health clinics and bring best practices and technical assistance to such clinics across the country.
For more than 30 years, The Family Van team has helped demonstrate that mobile health clinics are a simple, cost-effective way to reduce avoidable illnesses among the millions of people around the country who don’t have adequate access to medical care, including those who live in rural and urban health care deserts and those without health insurance. Such clinics can provide screenings; education; and primary, specialty, and preventive care in a health system that tends to focus on managing diseases that have already developed.
Every hypertensive stroke, late cancer diagnosis, or case of diabetic complications that a visit to a mobile health clinic helps prevent represents a huge savings in human suffering and medical spending, The Family Van founder Nancy Oriol, faculty associate dean for community engagement in medical education at HMS and an HMS associate professor of anaesthesia at Beth Israel Deaconess Medical Center, said at a recent TEDx talk.
For every $1 spent on mobile health, U.S. health systems save $19, Oriol said. The screening tests and outreach that mobile clinics provide avert thousands of emergency room visits every year and prevent thousands of early deaths, she said.
The Family Van leaders helped pioneer this model of care and have played an important role in growing the number of clinics on wheels in the United States from a handful in the 1990s to thousands today.
The loss of federal funding threatens to stall recent progress.
Low cost, high impact
Oriol was inspired to start The Family Van in 1992 after she cared for a woman who needed an emergency C-section that could have been avoided if the mother had known that her headaches were a critical warning sign of preeclampsia in late-term pregnancy.
To help prevent similar situations in the future, Oriol and colleagues from the local community developed a vision for bringing care into the community. They outfitted a van staffed with community health workers and other health professionals to travel around Boston. The program screens and refers, educates and counsels, connects community members to health centers and social services resources, and builds trusted relationships that help build clients’ self-confidence and understanding of how to interact with health systems to get the care they need.
The Family Van has served more than 75,000 clients over the years, including 1,430 individuals last year. They’ve also mentored more than 1,200 students, including undergraduate and medical students, and are an integral part of community-based medical education at HMS.
As the mobile health sector grew, Oriol and colleagues wanted to turn the anecdotes they kept hearing about money and lives saved into hard evidence. In 2009 they published Calculating the Return on Investment of Mobile Healthcare, which launched Mobile Health Map. Mobile Health Map has gone on to develop and share tools to quantify the clinical and economic impact of mobile health clinics’ preventive efforts, published research, and shared evidence with policymakers and health systems.
More than 1,300 mobile health clinics have joined Mobile Health Map. There are now more than 3,000 mobile clinics in the United States that together delivered an estimated 10 million visits last year.
Needed collaboration cut short
The CDC grant was meant to help strengthen clinical and public health systems around the country by improving the integration of existing mobile health clinics into their work, said Mary Kathryn Fallon, associate director of finance and operations for The Family Van and Mobile Health Map.
One key part of the project was a series of intensive learning collaborations. In the first year of the grant, these collaborations included 15 mobile clinics from 13 states.
By the time the grant was terminated, each of the participating clinics was already using the skills they had learned to identify and serve their communities’ health needs more effectively and efficiently.
The grant also enabled Mobile Health Map to provide individualized technical assistance to between three and five additional mobile clinics per week. And the funding allowed the HMS team to host webinars for the broader mobile health community and begin to build out a digital hub for sharing tools to help mobile health clinics customize their own community building and strategic planning.
This was a strong start, but much was left to do, Fallon said. The five-year plan for the grant was to expand this work to reach more clinics, deepen knowledge across the sector, and help more clinics reach their potential to alleviate suffering and make U.S. health care more efficient.
The Family Van and Mobile Health Map receive support from Harvard University and its affiliated hospitals and from several foundations and charities. During this turbulent time, several local funders have increased their support to The Family Van, underscoring their commitment to the value of the work. In addition, a grant from the Harvard Salata Institute for Climate and Sustainability to Gary Adamkiewicz, associate professor of environmental health and exposure disparities at the Harvard T.H. Chan School of Public Health, will enable The Family Van to continue their participation in a randomized controlled trial focused on climate risks to health in underserved Boston neighborhoods. This is a scaled-back version of a larger project that had received funding from the National Institutes of Health. That grant was also canceled.
Everyone is grateful for this support, Fallon said, and it has been necessary for The Family Van’s direct service in Boston. However, she added, the loss of the federal funding directly impacts Mobile Health Map’s national work, which affects the difference other clinics can make in their own local communities.
“At a time when the U.S. health system is straining to reach all the people who need help, when hospitals are going bankrupt, when more and more of our paychecks are going to cover the rising costs of health care, this is a moment for mobile health clinics to shine,” Fallon said. “Just a small investment makes a huge difference.”
