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It was a humid evening in August 1975, as the young streetworker Steve Disenhof drove the Bridge Over Troubled Waters (Bridge) Medical Van to its next stop in Harvard Square. Long-haired and lanky with a kind demeanour, Steve was the ideal guide to navigating Boston.1 That night, he was at the wheel of the van, a dilapidated Winnebago camper, with a nurse, a paediatrician and a new doctor volunteer in tow. Leaving Kenmore Square, the volunteer commented to the group that he did not understand how runaway youth survived day-to-day.1 2 The paediatrician concurred, but very firmly asserted, these were throwaways, not runaways. Meanwhile, the nurse inventoried supplies as the van rumbled through the streets, and a group of kids lined up to be seen.
The Bridge van was the beginning of a 1970s healthcare experiment, bringing what its founders called ‘biosocial care’ to Boston’s street youth. Since the early 20th century, mobile health units had been deployed for public health surveillance in the USA, but this new usage paid attention to a growing problem. Bridge provided medical, social and psychological services, and the van and its parent organisation’s social services continue, if not thrive, nearly 50 years later. Today, paediatricians and policy makers still explore the dilemma of homeless youth, an estimated 2.5 million people in the USA in 2018.3 These individuals face significant health challenges, both acute and chronic. By recounting the story of the Bridge programme, I describe a then-novel public health intervention and assess its limitations for serving a marginalised group.
Contributors SVS conceptualised and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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