Phillip Levy is an Assistant Professor of Emergency Medicine and Assistant Professor of Physiology at Wayne State University and the Assistant Vice President for Research at Wayne State University Department of Emergency Medicine.

Phillip Levy, MD

Mobile Health Units Aim to Close Gaps in CKD Screening Access

Mobile health unit–based screening programs are emerging as a strategy to address gaps in 

 detection, particularly among populations without the access to routinely engage with traditional healthcare systems.

In Detroit, Michigan, investigators developed a community-based screening model aimed at reaching individuals at elevated risk for cardiometabolic disease who may not otherwise access preventive care. The population-wide screening program, found 11-13% had CKD ≥ stage 3, double the US population’s 6% reported national average.

“We provide care in a community that suffers disproportionately from early onset of things like heart disease and kidney disease and strokes secondary to poorly controlled risk factors like high blood pressure, diabetes, hyperlipidemia,” study investigator, Phillip Levy, an Assistant Professor of Emergency Medicine and Assistant Professor of Physiology at Wayne State University and the Assistant Vice President for Research at Wayne State University Department of Emergency Medicine, shared in an interview with 

 “There are high rates of smoking and obesity as well in the community, low rates of physical activity, socioeconomic challenges, and environmental exposures, all of which create outsized risk for the population we serve.”

Addressing Gaps in Preventive Care Access

The initiative reflects a broader shift in care delivery, informed in part by frontline experience treating advanced disease in acute care settings. Rather than continuing to intervene at late stages, the program was designed to move upstream and engage individuals earlier, particularly those who do not routinely seek care in traditional settings such as emergency departments or outpatient clinics.

To guide deployment, investigators developed geospatial analysis tools to identify high-risk communities using county-, ZIP code–, and census tract–level data, incorporating both clinical and social risk factors.

From Pandemic Response to Community-Based Screening

The model expanded during the COVID-19 pandemic, when mobile units were initially deployed for community-based testing. High levels of engagement, particularly willingness among community members to undergo blood-based testing, highlighted an opportunity to broaden screening beyond infectious disease.

In response, the program incorporated additional testing for hemoglobin A1c, kidney function, and lipid levels, using the point of community engagement to identify cardiometabolic risk earlier.

This evolution led to the development of a “portable population health” model, which integrates blood pressure screening using gold-standard triplicate protocols, laboratory testing, social determinants of health assessments, and coordinated linkage to follow-up care through community health workers.

Shifting Toward Population-Based Screening Models

Findings from the initiative support a broader reconsideration of how preventive screening is delivered, particularly in high-risk communities where clinic-based models may be insufficient.

“What we’re really striving toward… is the idea that prevention should be community-based, not office-based,” the investigator said. “Prevention screenings shouldn’t require a doctor to say that person needs to be screened for kidney disease, because we all need to be screened.”

The model emphasizes bringing screening directly to communities, reducing reliance on patient-initiated engagement with the healthcare system and addressing barriers such as transportation, time constraints, and competing life demands—even among insured populations.

Barriers to Scaling Community-Based Models

Levy noted that scaling this approach will require rethinking how care is delivered and reimbursed. Current healthcare models are largely structured around clinic-based services and physician-led encounters, which may not align with community-based, team-driven prevention strategies.

Expanding reimbursement pathways for services delivered in nontraditional settings, as well as supporting team-based care models, may be critical to broader adoption.

Editor’s Note: Levy report relevant disclosures with Cielo Foundation.

Brook RD, Korzeniewski SJ, Foster B, et al. Screening for Chronic Kidney Disease by Mobile Health Unit Outreach. JAMA Network Open. 2026;9(3):e262312. doi:

https://doi.org/10.1001/jamanetworkopen.2026.2312

This City’s CKD Stage ≥ 3 Incidence is Double The US National Average. HCPLive. Published 2026. Accessed April 20, 2026. 

https://www.hcplive.com/view/city-ckd-stage-3-incidence-double-us-national-average

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Levy describes the goal of deploying mobile health units in Detroit to close gaps in CKD screening. 

This City’s CKD Stage ≥ 3 Incidence is Double The US National Average

A population-wide screening program deployed by mobile health units in Detroit, Michigan, found 11-13% had 

 ≥ stage 3,  double the US population’s 6% reported national average.

Additionally, results from the cross-sectional study of the public health outreach program, which used the CKD-EPI 2021 eGFR creatinine formula, found increased incidence among at-risk subgroups, including older individuals, adults who identify as black, and patients with diabetes.

The Gap and Goal Behind CKD Screening in Disadvantaged Communities

“A lot of what we’re striving to do is just get people to want to know their numbers, want to know the information that’s going to lead them to think perhaps differently about prevention, or get awoken to do something more than nothing, which is going to be the only way to take a stage 3 chronic kidney disease patient and keep them off dialysis,” study investigator, Phillip Levy, an Assistant Professor of Emergency Medicine and Assistant Professor of Physiology at Wayne State University and the Assistant Vice President for Research at Wayne State University Department of Emergency Medicine, shared in an interview with 

This community health program took place in Detroit, Michigan, where 31 to 34% of residents live below the federal poverty line, classifying these neighborhoods as disadvantaged. As such, a majority of individuals reside in environments with social determinants of health that put them at an increased risk for developing CKD. The major social barriers to screening for patients in these communities often remain awareness and access.

HCPLive’s most recent Crisis Point covers the 

cause and effect of neighborhood disadvantage on kidney disease

To address this, the population health program deployed mobile health units across metropolitan Detroit to improve earlier detection of cardiovascular-kidney-metabolic risk factors, decrease area-wide morbidity and mortality, and reduce health disparities.

How Did The Mobile Health Units Operate? What Did We Learn?

5 to 7 Mobile health units were deployed with nonphysician staff, 5 to 6 days per week, to partner locations. After they took a brief medical history, patients ≥ 18 years of age were offered screenings for high blood pressure (BP), diabetes (ie, hemoglobin A[HbA] measurement), and CKD using eGFR.

The cohort included 5128 unique patients with 5973 encounters. Investigators reported that 2293 patients (44.7%) had eGFRs of 60 to 89 mL/min/1.73 m2, whereas 579 (11.3%) had ≥ CKD stage 3(eGFR <60 mL/min/1.73 m2). As reported, patients with older age, Black race, and diabetes, defined as HbA1c ≥6.5%, were associated with higher risks for ≥ CKD stage 3

I think it’s critically important to recognize that when an older individual, an older Black individual, is found to have CKD, it didn’t happen yesterday. It’s been ongoing for a little while,” Levy said. “I’s really important for clinicians to not only impress upon their patients, but educate their patients to be ambassadors for their families and their communities—to say, you’re here, you’re doing the right thing by coming to the doctor’s office today, but what about your aunt, your uncle, your cousin, your mom, your dad?”

A limitation to these findings was an inability to measure urine albumin to creatinine ratio, which investigators suspect, if added, would result in increased rates of CKD stages.

Detroit Partnership on Economic Mobility. University of Michigan. Accessed April 16, 2026. 

https://poverty.umich.edu/projects/detroit-partnership-on-economic-mobility/

Data from a study deploying mobile health units across Detroit, Michigan, found CKD stage ≥3 rates double the national average and increased rates in at-risk subgroups.


Phillip Levy, MD

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