The Case for School-Based Health Centers | California School-Based Health Alliance

Federal Recommendations | SBHCs & Health Equity | Case Studies

The number of school-based health centers continues to grow because the need is great and impact is deep.

Doctors know it: When we can prevent health issues from developing into something worse, that to me epitomizes the strength of a school-based health center.

Educators see it: The reality is that many of our children come to school sick because they have nowhere else to go. So it just makes sense to have a school-based health clinic as a key component to providing a quality education.

Students feel it: Our school health center has everything! Comfort. Respect. Honesty.

School is a hard place for many young people. They might be labeled as ‘low achieving’ or ‘angry,’ ‘apathetic’ or ‘defiant.’ When these young people come into a space that lifts up their hopes and dreams, they are able to re-position themselves in their own lives and within the school community as activists, artists, advocates and leaders. This chance to matter, to be an agent of change, has a profound impact on young people’s sense of themselves and their imaginative capacity to hold a positive future.

Jenn Rader, Executive Director, The James Morehouse Project, El Cerrito High School

SBHCs increase access to health care.^(1,2,3,4,5)
SBHC users are likely to use primary care — both medical and behavioral health — more consistently.^(6,7,8,9)
SBHC users are more likely to have yearly dental and medical check-ups.^(10,11)
SBHC users are less likely to go to the emergency room or be hospitalized.⁽¹²⁾

Read more about how SBHCs positively impact student health.

Research shows that SBHCs have a positive impact on absences, dropout rates, disciplinary problems and other academic outcomes.⁽¹³⁾
Students receiving SBHC mental health services improve their grades more quickly than their peers.⁽¹⁴⁾
States with SBHCs that serve as Medicaid providers have higher student achievement results.⁽¹⁵⁾
States that oversee health education and health services have higher test scores and lower dropout rates.⁽¹⁶⁾

Read more about how SBHCs positively impact student learning.

Research shows that investments in SBHCs generate savings through reduced use of high cost services, thereby increasing access without increasing overall Medicaid expenditures.⁽¹⁷⁾
Studies have also found that SBHCs reduce inappropriate emergency room use ^{(18, 19)}, inpatient, drug and emergency department use ⁽²⁰⁾, and hospitalization among children with asthma.⁽²¹⁾
School-based immunization initiatives prevent disease and can also save money for society.⁽²²⁾

(1) Soleimanpour S, Geierstanger SP, Kalley S, et al. (2010). The Role of School Health Centers in Health Care Access and Client Outcomes. Am J Pub Health. 100(9): 1597-1603.
(2) Guo JJ, Wade TW, & Keller KN. (2008). Impact of School-Based Health Centers on Students with Mental Health Problems. Public Health Reports. 123: 768-780.
(3) Wade TJ, Mansour ME, Guo JJ et al. (2008). Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle School. Public Health Reports. 123: 739-750.
(4) Allison MA, Crane LA, Beaty BL, et al. (2007). School-Based Health Centers: Improving Access and Quality of Care for Low-Income Adolescents. Pediatrics. 120(4): e887-e894.
(5)Kaplan DW, Brindis CD, Phibbs SL, et al. (1999). A Comparison Study of an Elementary School-Based Health Center. Arch of Ped and Adol Med. 153: 235-243.
(6) Allison et al (2007).
(7) Kaplan et al (1999).
(8) Anglin TM, Naylor KE, & Kaplan DW. (1996). Comprehensive School-Based Health Care: High School Students’ Use of Medical, Mental Health, and Substance Abuse Services. Pediatrics. 97: 318-330.
(9) Santelli JS, Kouzis A, & Newcomer S. (1996). School-Based Health Centers and Adolescent Use of Primary Care and Hospital Care. J of Adol Health. 19(4):267-275.
(10) Allison et al. (2007).
(11) Kaplan et al. (1999).
(12) Allison et al. (2007).
(13) Geierstanger SP, Amaral G. School-Based Health Centers and Academic Performance: What is the Intersection? April 2004 Meeting Proceedings. White Paper. Washington , DC : National Assembly on School-Based Health Care; 2005.
(14) Walker SC, Kerns SEU, Lyon AR, et al. (2010). Impact of School-Based Health Center Use on Academic Outcomes. J Adol Health. 46: 251-257.
(15) Vinciullo FM & Bradley FM. (2009). A Correlational Study of the Relationship Between a Coordinated School Health Program and School Achievement: A Case for School Health. J of School Nursing. 25(6): 453-465.
(16) ibid.
(17) Guo JJ, Wade TJ, Pan W, et al. (2010). School-Based Health Centers: Cost–Benefit Analysis and Impact on Health Care Disparities. Am J Public Health. 100: 1617–1623
(18) Juszczak L, Melinkovich P, Kaplan D, Use of health and mental health services by adolescents across multiple delivery sites. J Adol Health 2003;32S:108-118.
(19) Santelli J, Kouzis A, et al. SBHCs and adolescent use of primary care and hospital care. J Adol Health 1996; 19: 267-275.
(20) Adams EK, Johnson V., An elementary SBHC: can it reduce Medicaid costs? Pediatrics 2000 Apr;105(4 Pt 1):780-8.
(21) Webber MP, Carpiniello KE, Oruwariye T, Yungtai L, Burton WB, and Appel DK . Burden of asthma in elementary school children: Do SBHCs make a difference? Arch Pediatr Adolesc Med. 2003; 157: 125-129.
(22) Schmeir J, Li S, King JC et al. (2008). Benefits and Costs of Immunizing Children against Influenza at School: An Economic Analysis based on a Large-Cluster Controlled Clinical Trial. Health Affairs. W96-W104.

Federal Recommendations | SBHCs & Health Equity | Case Studies

Impact on Health Care

Impact on Academic Performance

Impact on Health Care Costs

Citations