After more than two years of disrupted classes during the pandemic, it’s clearer than ever that schools are more than just places to learn: they’re vital safe places for students to build friendships, get wholesome meals and talk with trusted adults. And they can be more – schools can also provide health care.
About 3,000 school health centers operate in more than 30 US states, offering primary and preventive care to students who live in medically underserved areas. Staff at the centers treat flu, asthma, diabetes and other common ailments. They provide vaccinations and screening for dental, vision and hearing problems, and some provide mental health and reproductive health care. These clinics, which are often partnerships between school districts and local community health organizations and hospitals, provide services to children who need them most and who are most at risk of falling behind in school because their health needs remain dissatisfied.
The pandemic has been hard on existing school health centers, and as we count the years of education lost, it is time for government at all levels to recognize that all children need accessible and affordable health care. As lawmakers prepare budgets, reallocate funds and begin a new school year, existing clinics must be able to operate without budget fears, more dollars must go to school clinics, and more community partners must be financially and physically involved in health care efforts for the children who miss them.
“Healthy kids learn better,” says Robert Boyd, president and CEO of the School Health Alliance (SBHA), a nonprofit organization that promotes school health centers. More than 20 million children in the US do not have adequate access to health care, and the most direct way to address this need is to bring doctors to them. “A lot of their parents can’t get away from work to take them to appointments,” says Boyd. “And even if they manage to escape work, children often miss a whole day of school. By having the health center right there in the school facility, they can do what they need to do and get back to class.” And schools are often among the most trusted institutions within communities, making it easier to reach students who are concerned to visit doctor’s offices or whose parents do not trust outside providers.
Providing health care through schools has been shown to improve children’s physical well-being and educational outcomes. A 2005 study in Journal of Adolescent Health found that after opening health centers in US public schools, their students’ risk of hospitalization for asthma decreased 2.4 times, and their asthma emergency room trips decreased by 33.5 percent. Other studies show that school-based clinics can increase vaccination rates among students, reduce mental health problems, and increase student contraceptive use. When it comes to education, kids who use such centers have improved attendance and grades, are more likely to be promoted to the next grade and less likely to be suspended — and are generally more prepared for college. Based on all of this evidence, a Centers for Disease Control and Prevention task force recently recommended school-based health centers as a key strategy to promote health equity—that is, to reduce access disparities that exist among wealthier, more privileged populations. and everyone else.
Yet most school communities that could desperately use such clinics do not have them. In 2021, Congress appropriated $5 million to support new and expanded services at school health centers. That money funded 25 facilities — but the program received more than 300 applications. And less than half of US states currently fund school health centers. Although clinics can also bill Medicaid and insurance for students who have coverage, they need stable funding for operating costs, including hiring well-trained staff.
Many existing centers had to close temporarily or permanently during the pandemic, and centers struggled to retain staff and funding. One bright spot is that more than 60 percent of centers that responded to an SBHA survey began offering telehealth services between 2020 and 2021, expanding their reach. And many have been able to administer COVID vaccines to populations that did not have access to the life-saving vaccines. Getting the care children need, where they need it, has always made sense and is more urgent than ever. The moment is right to expand school health centers for all underserved students.
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