ABSTRACT
Underserved counties in the United States continue to face persistent disparities in healthcare access, outcomes, and infrastructure. These areas, often characterized by rurality, high poverty rates, and provider shortages, experience preventable health crises due to limited public health resources. This paper proposes a conceptual model for strengthening public health infrastructure in underserved U.S. counties through the strategic deployment of Mobile Health Units (MHUs). The model integrates mobile health technology, community-based workforce development, and data-driven service delivery to bridge geographic and systemic gaps in healthcare provision. Drawing on best practices from federal rural health initiatives, public-private partnerships, and community health programs, the proposed model is anchored on four pillars: (1) Accessibility and Reach, deploying MHUs equipped with diagnostics, telehealth tools, and preventive care services to medically isolated areas; (2) Community Integration, involving local stakeholders in the planning, staffing, and cultural adaptation of mobile services; (3) Digital Health Infrastructure, utilizing real-time data systems for health surveillance, referral coordination, and outcome tracking; and (4) Sustainability and Scalability, aligning with Medicaid reimbursement strategies, nonprofit partnerships, and federal grants to ensure long-term operation. Case studies from Appalachia, the Mississippi Delta, and Native American reservations demonstrate the effectiveness of MHUs in increasing immunization rates, chronic disease screening, maternal health access, and pandemic response. The conceptual model emphasizes a hub-and-spoke approach, where MHUs act as mobile extensions of local health departments or Federally Qualified Health Centers (FQHCs), thus reinforcing rather than replacing existing health structures. The model also identifies barriers such as workforce shortages, broadband limitations, and regulatory complexities, proposing mitigation strategies including remote training, mobile-enabled EHRs, and policy advocacy. Ultimately, the model offers a flexible, replicable blueprint to strengthen public health resilience and equity in high-need U.S. counties.
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