School-Based Healthcare (SBHCs) are primary care clinics based on primary and secondary school campuses in the US. Most SBHCs provide a combination of:
- Primary care
- Mental health care
- Substance abuse counseling
- Case management
- Dental health
- Nutrition education
- Health education
- Health promotion
SBHCs operate as a partnership between the school district and a community health organization. These organizations include a community health center, a hospital, a county health department. The majority of SBHC students are eligible for National School Lunch, according to most of the reports. It is actually a common indicator of low socioeconomic status. Giving children and adolescents access to health care at school puts them in a better position to learn. Students who use SBHCs will benefit in many ways. They spend more time in class, and they seem to be sick less often than others. Often, they don’t have to take too much time from school to make appointments.
School-based healthcare usually serves in classrooms or on the premises of the school. They work together within the school to become an integral part of the school. And they’re providing a range of services. These services meet the specific physical and behavioral health needs of young people. They recruit a multidisciplinary team of providers to take care of students. The staff includes doctors, dentists, nurses, social workers, and other health practitioners. And HBHCs provide healthcare care by accredited health providers such as hospitals.
They ask parents to sign the permission of their children to access a wide range of services. They have an advisory council to provide planning and supervision. The Board is made up of elected leaders, caregivers, youth, and family groups.
How It Started?
New York City authorities launched the first school wellness program in the United States in 1894. Its purpose was to evaluate children. If necessary, children with infectious diseases were excluded from the classroom. In 1902, the service grew to include the nation’s first school nurse. School health services extend throughout the country. Health screening and prevention of infectious diseases have been their main priority.
President Lyndon Johnson’s War on Poverty in the mid-1960s is credited with reflecting on the importance of health problems among poor school-aged children.
In 1967, Philip J. Porter was Head of Pediatrics at Cambridge City Hospital, Massachusetts. He was also Head of Maternal and Child Welfare at the Public Health Department. So at that time, he was starting to resolve this topic. He appointed a nurse to serve in elementary school to provide primary medical services to enrollees. In the years that followed, four new health centers were opened in Cambridge Colleges.
The first School-Based Healthcare was opened in Cambridge, Massachusetts (1967), Dallas, Texas (1970), and St. Paul, Minnesota (1973). The first two were initiated because their creators hoped that school-based health services should offer accessible, comprehensive healthcare for poor children. Also, Pinkston High School was the first high school country to provide quality treatment. Because the treatment was delivered by nurses, doctors, social workers, and nutritionists.
In 1978, grants by the Robert Wood Johnson Foundation stimulated a growth in the number of centers throughout the United States. These early centers have shown that they have been successful in growing children’s access to care.
Pediatric nurse practitioners (PNP) have a part to play as advanced nurses. They have the expertise to deliver primary health services to children who have begun to emerge. With a seed grant of $7,000, the first school nurse practitioner degree program was developed at Colorado University in the late 1960s. That was in reaction to a general frustration with the small role played by the school nurse. It also recognized the need for on-site school wellbeing.
School Nurses In SBHC’s
School nurses are an important part of the SBHC. This is because they help discourage and reduce the lack of students in educational institutions. So, the main objective of a school nurse is to ensure that children are well. Because they will guarantee the students have decent attendance.
The school nurses in SBHC have seven distinct characteristics. They help students succeed academically. A school nurse:
- Takes care of students on a one-on-one basis
- Leads the healthcare facility
- Offers preventive screening and referrals, as well as health promotion
- Serves as a link between parents, teachers, health-care providers, and the general public
The separate school districts shall decide the health care provided by the schools. According to the American Academy of Pediatrics (AAP), school nurses can provide those programs that satisfy the minimum requirements. The minimum requirements include:
- Taking care of students who need extra medical attention
- Making plans for dealing with emergencies
- Programs for health screening
- Immunization verification
- Reports on infectious diseases
- A framework for identifying students’ chronic health care conditions, which could have an effect on their academic performance
Current Status Of School-Based Healthcare
The initial survey conducted by the Center for Population Options in 1985 identified 35 centers throughout the country. But over the last 40 years, school-based healthcare has expanded from a handful to 1,909 in 45 states.
Outcomes Of School-Based Healthcare
Researchers have investigated the effect of SBHCs on many areas of health and education. So the findings of these studies are the followings:
1. Access To Care
Children with the most unmet needs profit most from SBHC programs. SBHCs eliminate the inequalities in access to health care for African Americans and students with disabilities.
The Bienestar Health Program has good evidence that supports its potential to increase positive health habits and decrease risk factors for type 2 diabetes in Mexican-Americans and other at-risk teens.
Rush University College of Nursing runs health centers in three high schools. They offer useful sexual health programs to students who are mainly African-American. But there are racial disparities. Asian students are less likely to have access to programs than their Black and Latino peers.
2. Clinical Services
School-based healthcare encourages the immunization of children. These are much more efficient than neighborhood health centers. So children with asthma benefit immensely from SBHCs. They are faced with fewer emergency department visits and relaxed movement restrictions. Children with asthma have also increased attendance at kindergarten.
SBHCs Have Also Been Shown To Be Effective In Working With Adolescents Who:
- Demonstrate signs of depression
- Make use of substances
- Have a sexual encounter
3. Educational Impact
SBHCs help reduce school absences and promote healthier lifestyles. In Connecticut, 96.7 percent of students using community-based centers return to school on the same day.
Researchers completed a youth survey in the San Francisco Unified School District. It indicates that the use of SBHCs by students is consistent with favorable learning results. This is especially due to student self-reported expectations of school properties and a nurturing relationship with an adult SBHC employee.
4. Cost-Savings
SBHCs result in cost savings for Medicaid due to less usage of emergency rooms and hospitalizations.
5. SBHCs Serve All School-Levels
In primary schools (20 percent), intermediate/junior high schools (15 percent), high schools (30 percent), and a combination of elementary, middle, and secondary schools (21 percent ). They are found in urban (59%), rural (27%), and suburban (14%) areas throughout the United States. The centers also adapt their programs and outreach directly to the student body of the school. Seventy percent of the student body of SBHC schools is a minority. These included Hispanic/Latin (36.8 percent), Black (non-Hispanic/Latin) (26.2 percent), Asian/Pacific Islander (4.4 percent), Native American/Alaskan Native (1.7 percent), and “other” (1.4 percent ). Youth centers are staffed by one or two health professionals. They include nurses, medical assistants, social workers, drug misuse consultants, and mental health providers.
