The Fry Foundation Health Program looks for organizations that develop thoughtful strategies to help Chicago's low-income citizens gain access to high-quality health care. The strongest programs create links between the health care system and community-based organizations and are knowledgeable about the people they hope to serve. The St. Bernard Hospital Pediatric Mobile Health Unit brings basic health care to young people and meets them where they are—in schools.

In Englewood, immunization rates for children and teenagers are dangerously low, exposure to environmental hazards like lead paint is dangerously high, and chronic conditions such as asthma and obesity are widespread. Such health care concerns are unnecessarily prevalent in a community where half of the residents live below the federal poverty level. Lack of health insurance and a dearth of high quality health care providers mean that for many residents it is nearly impossible to secure the kinds of interventions that could alleviate this bleak reality.

Since launching its Pediatric Mobile Health Unit in 2003, officials at St. Bernard Hospital and Health Care Center have made significant strides in meeting the health care needs of children living in Englewood and Chicago's other south side neighborhoods. In visits to about 50 area schools and youth programs annually, the three individuals who staff the 40-foot-long medical office on wheels—an administrator, a nurse practitioner, and a clinical assistant—make contact with about 2,000 children each year. In the unit's examination room, with basic equipment and laboratory facilities, the team diagnoses everything from colds to pregnancies. The staff provided more than 1,200 immunizations last year, performed more than 1,500 comprehensive physical examinations, and referred children with no primary health care providers to a health center.

"We provide some basic health care opportunities that other people may take for granted," says the mobile unit's manager,Walter Repuszka, who maintains relationships with administrators and nurses at all the schools the unit serves, secures parental permissions for medical treatments and referrals, and drives the retooled vehicle to more than 150 annual site visits.

Those visits and physicals are often the only contact with a health care professional a student is likely to have, Repuszka adds."We bring essential care to kids who might not otherwise receive these very basic treatments. By providing immunizations we are able to keep kids in school before they are turned away for not having current vaccines. And our physical exams may find a clean bill of health or perhaps a treatable condition that can be addressed through a referral or just some good advice."

That advice is likely to come from nurse practitioner Sarah Lau and clinical assistant Kenya Benniefield. "We're seeing kids who are 11 and 12 years old who are just getting the immunizations they should have received at age 4," says Lau.

"And I would estimate that half of the children we see need treatment for asthma." In addition to referrals to the primary health clinic, she frequently refers these children to a local coalition that provides home care, medication, patient education, and other services for asthma patients.

Following up on lab results and referrals to other health providers can be a challenge, but upgrades in the mobile unit's technology are helping to address that concern. For instance, it takes between one and two weeks to receive results from a standard test to determine levels of exposure to lead paint."With a new machine we have in our unit, we can now get those results in about three minutes," she says, and if results indicate significant exposure, parents can be contacted immediately or, when that is not possible, a note can be sent home with the child urging immediate action.

Even as the mobile unit team addresses serious health concerns like lead paint exposure and asthma, it is also helping students stay connected to school. Just ask Stacy Douglas, coach of the Corliss High School football team. He recently brought several of his players to the mobile unit to receive sports physicals, a requirement for every player on a Chicago high school sports team."Most of these kids are pretty much on their own and have no other options for getting this kind of medical treatment," he says. "For a lot of them, football is keeping them out of trouble. For many it is keeping them in school and for some it will be the ticket to a college education.Without the physicals, they can't play."