School-Based Health Centers (SBHCs)
Reasons for Policy
- Young people today face worse health than their parents did and meeting the health care needs of school-aged children remains a challenge.1
- More than two-thirds of the 11.2 million uninsured children and adolescents in the United States who were eligible for Medicaid or the SCHIP were not enrolled in 2000.2
- Community-based Organizations
- Local Health Department
- Local Medical Community
- Non-profits/Community Organizations
- Parent Teacher's Association
- Employ a combination of physicians, physician assistants, and nurse practitioners as well as mental health professionals and nursing staff.
- Provide a variety of primary preventive services, physical health services, and mental health and counseling services in a manner that is culturally sensitive, confidential, comfortable, and safe.
- Form advisory boards to involve the community in planning and advising.
- Provide health services to students with unmet health needs and inadequate health resources.
Level of Evidence Available to Evaluate Effectiveness of Policy
For all policies we describe on this website, we have applied the Standards of Evidence as defined by Flay et al. (2005) in the Standards of Evidence document published by Prevention Science.
The effectiveness level of this policy is 2: Policies with Consistent Evidence from High-Quality Observational Studies.
The levels of effectiveness as noted are:
- meets criteria for policy effectiveness (consistent, positive outcomes from at least two high-quality experimental or quasi-experimental trials using a comparison group or interrupted time series design);
- consistent evidence available linking policy with positive outcomes from high-quality observational studies only;
- insufficient evidence available for policy or policy components.
- SBHC’s effectively increases accessibility to health services by reaching a broad scope of eligible students. Between 58% and 75% of students eligible to receive services at SBHCs enroll and 72% of those enrolled use SBHC services.4
- More research is needed on the health outcomes achieved with SBHCs.4
- Seattle Washington passed a levy that funds school health clinics in all high school and selected middle schools in the city. http://www.seattle.gov/neighborhoods/education/edlevy.htm http://www.seattle.gov/neighborhoods/education/implementation&evaluation.pdf#page=12 http://www.kingcounty.gov/healthservices/health/child/yhs.aspx
- New York City New York has 122 school-based health centers providing primary, preventive, first aid, and emergency care.
Links to Policy Examples
- Seattle Washington, Ordinance # 121529 allocates $2,605,000 for school-based health clinics
- New York City New York: Regulation of the Chancellor Number A- 701 Section VII.
Tylee, PA, Haller, DM, Graham, T, Churchill, R, & Sanci, LA (2007). Youth-friendly primary-care services: how are we doing and what more needs to be done? The Lancet, 369(9572), 1565-1573. ↩
American Academy of Pediatrics. Children’s Health Insurance Advocacy Fact Sheets. Available at: http://www.aap.org/advocacy/facts00.htm.2000. Accessed October 12, 2002. ↩
Flay, BR, Biglan, A, Boruch, RF, Ganzalez Castro, F, Gottfredson, D, Kellam, S, Moscicki, EK, Schinke, S, Valentine, JC, & Ji, P (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151-175.
Santelli, J,Morreale, M, Wigton, A, & Grason, H (1996). School health centers and primary care for adolescents: A review of the literature. Journal of Adolescent Health, 18, 357-366. ↩