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History of SBHCs

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Saved by Julianne Fylstra
on November 20, 2009 at 2:50:04 am


History of School-Based Health Centers




First, why are school-based health centers important?



  • The effect of poor health on student achievement has become a popular issue in contemporary American education.
  • Studies have shown that unhealthy diets lead to unhealthy children, and unhealthy children can experience a wide array of learning difficulties.
  • Starting at age 5 or 6, children spend a large proportion of their waking hours at school, so schools can play a large role in student health.
  • A National Center for Health Statistics survey of children found that 68% of children whose parents have some graduate school education are healthy, whereas only 35% of children whose parents have less than a high school education were healthy.
  • The same survey showed that 64% of children from upper income families are healthy, compared to 35% in low-income families.
  • Additionally, children in the lowest income bracket are 2-4 times less likely than those in the highest income bracket to have medical insurance; they are also less likely to have had routine care in the past 2 years, making school clinics a valuable service.




Source: http://extend.schoolwires.com/clipartgallery/images/32415670.gif











  • 1897: The New York City Department of Health hires 150 doctors for an hour a day to inspect poor children; students with contagious diseases are sent home.
  • 1902: The New York City Schools hires the first school nurse as a new public health strategy for improving the health of schoolchildren. More school nurses are hired soon after.
  • 1903: The number of children excluded from classes for health reasons drops by 90% due to the presence of these nurses. School nurses are seen to be highly effective for maintaining good student health, and thus they became the status quo for at least the next fifty years.
  • 1914-1918: World War I has a clear impact on school health programs; the poor physical condition of many war draftees led to a greater emphasis on health care for youth.
  • 1930s and 1940s: During the Great Depression and World War II, there is less emphasis on state and federal funding for school-related health services, as these funds are redirected to other crucial needs (i.e., alleviating growing rates of unemployment). The field of school health nursing experiences little growth.
  • 1950s: General shift in consciousness as the American public starts to demand more substantial health interventions for adults and children alike.
  • 1967: First school-based health clinic (SBHC) takes hold in Cambridge, MA. Pediatrician Philip J. Porter hires a nurse practitioner to establish a clinic in an elementary school rather than in the Cambridge Health Department, completely changing the conventional school nurse role.
  • 1969: School-based health clinics open in two elementary schools in West Dallas, TX using federal funding from the War on Poverty. The clinics soon expand to high schools in the same city.
  • 1972: Robert Wood Johnson Foundation is created.
  • 1973: Medical center in St. Paul, MN starts a high school clinic to serve pregnant and parenting teens through their Maternal-Infant Care Program; reports of clinic’s success legitimizes school-based health centers as a new approach to adolescent pregnancy prevention.
  • 1978: Encouraged by the early success of these SBHCs, the New York state legislature consequently approves the first state grant to support the development of SBHCs.
  • 1978: The Robert Wood Johnson Foundation begins to fund projects in Chicago, Kansas City, Flint and Houston for SBHCs, including its School Health Services Program.
  • 1980s and 1990s: SBHCs continue to proliferate rapidly.
  • 1981: Robert Wood Johnson Foundation's Community Care Funding Partners Program launches.
  • 1984: First national conference of school-based health centers held in Houston, TX.
  • 1986: The Robert Wood Johnson Foundation funds the School-Based Adolescent Health Care Program, the first major grant effort focused on replicating SBHCs nationwide.
  • 1986: Opposition mounts as conservatives attack SBHCs. The Catholic Archbishop of the Los Angeles Diocese strongly criticizes the establishment of SBHCs at three high schools in the LA area because he is worried that they were “sex clinics.”
  • 1989: 150 SBHCs in the U.S.; still expanding.
  • 1991: SBHCs are called “appropriate vehicles for reaching youth” in a report called Healthy People 2000 by the U.S. Public Health Service. Government support for SBHCs legitimizes them in the eyes of the public as sources of healthcare.
  • 1994: The General Accounting Office, a non-partisan research arm of U.S. Congress, finds that “SBHCs do improve children’s access to health care."
  • 1996: 947 SBHCs in the U.S. - over 6 times as many as there were in 1989!   



Currently, there are 1800 school-based health centers in the United States; New York has the most at 187 clinics, with California in second place with 153 clinics. The greatest enrollment and number of users of these clinics are found in high schools and junior high schools.



Please click HERE to view the full report on the history of school-based health centers.





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