School-Based Health Centers

An Essential Part of Public Health

School-Based Health Centers Are an Essential Part of Public Health

By Faith Thornton

Adolescents are the future of our nation; they will eventually occupy coveted leadership positions in realms of science, mathematics, politics, education, and the arts.  Investments into health and development of adolescents secure the best future for all.

However, adolescents have one of the lowest rates of primary care use of any age group in the United States, according to the School-Based Health Alliance (2009). Inaccessibility of health care services is a major contributor to health care disparity. Lack of resources particularly in low income and rural communities leave community dwellers without adequate health care utilization, compromising health outcomes and warranting public health interventions (Hing E, Cherry DK, Woodwell DA, 2006). Poor health care access and utilization is influenced by factors that include lack of health care providers, difficulties in navigating the complex health care system, language barriers, and transportation (Redmond P, Needleman C, 2007). Being part of a racial or ethnic minority group, low socioeconomic status, or being a member of a family that has recently immigrated to the United States also contributes to decreased access to health services (Wise PH, 2004).

girl and docterA lack in regular health visits due to barriers in access and utilization contribute greatly to the disparities in health which have ramifications in other aspect of youth development (SCHA, 2009). Evidence shows that the health of students is linked to their performance in schools (CDC, 2014). Specifically, research found that vision; oral health, asthma, teen pregnancy, aggression and violence, physical activity, nutrition, substance use, and inattention and hyperactivity are key health problems that impede academic success by reducing student’s motivation and ability to learn (SBHC, 2009). School-Based health centers (SBHC) aim to alleviate disparities by providing health services and consequently improving outcomes.

Surveys show that adolescents seen in SBHCs are likely to receive recommended services such as abstinence counseling (76%), pregnancy testing (78%), crisis intervention (91%), STD testing and treatment (62%), mental health assessment and diagnosis (91%), and substance abuse counseling (77% (SBHC, 2009). Healthy students are better on all levels of academic achievement: academic performance, education behavior, and cognitive skills and attitudes (CDC, 2014). School based health centers serve at the intersection of primary care, public health, and education to safeguard the best possible health outcomes for students, according to SBHC (2009). The services delivered enable children and adolescents to thrive: contributing to their comprehensive health, conducive for optimal learning. Moreover, although the top priority of SBHCs is to provide health care for students in the school, many provide health care to family and community members. Nearly seventy percent (66.7%) of SBHCs provide access to families of students served, students from other schools, out-of-school youth, faculty, or members of the community (Lofink et al, 2013).

School-Based health provides many essential public health services.  The organization employs services from all three core public health functions: assessment, assurance, and policy development. SBHCs link people to needed personal health services and assure the provision of health. Services provided improve health of the community as well as improve students learning abilities by decreasing barriers that may accompany lack of health care resources. As part of health assessment, monitoring, investigation and diagnosis of health conditions is delivered in service to the population. Prevention efforts, early detection and treatment of health ailments help improve outcomes and decrease days missed from school.

One of the most essential public health services delivered by school-based health is the mobilization of community partnerships. The collaboration between health and school is convenient and beneficial to all stakeholders involved. The mission of school-based health is consistent with that of public health; to safeguard and promote of health and wellness of the population. From the efforts of school-based health centers, the greater field of public health can become familiar with benefits, beyond the positive implications of health, associated with investment in community health such as: improved adolescent development, school performance and completion, and the development of social capital that make a community thrive.


About the Author

Faith Thornton received her bachelor’s degree in Human Biology from Michigan State University and will be attending the university’s osteopathic medical school this summer. She is currently completing her master’s degree in Public Health and serving as intern at School Community Health Alliance of Michigan.


CDC (2014) Health and Academic Achievement. Retrieved on October 19, 2015 from

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Hing E, Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2004 summary. Advances in Data Analysis and Classification. Jun 23 2006(374):1-33. – See more at:

Lofink, H., Kuebler, J., Juszczak, L., Schlitt, J., Even, M., Rosenberg, J., and White, I. (2013). 2010-2011 School-Based Health Alliance Census Report. Washington, D.C.: School-Based Health Alliance

Redmond P, Needleman C. Reducing Barriers to Health Care: Practical Strategies for Local Organizations – Covering Kids & Families Access Initiative Toolkit. Hamilton, NJ: Center for Health Care Strategies, Inc.;2007. – See more at:

Wise PH. The transformation of child health in the United States. Health Affairs (Millwood). Sep-Oct 2004;23(5):9-25. – See more at:

School Based Health Alliance (SBHA) (2009) Retrieved on October 19, 2015 from

School-Community Health Alliance of Michigan (SCHA-MI) (2014) retrieved on October 19, 2015 from

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