Source: National Survey of School-Based Health Centers, 1997-98, Making the Grade, The George Washington University, Washington, D.C.
|Where are they?School-based health centers have grown rapidly during the 1990s, increasing from about 200 in 1990 to 1157 in 1998. They are found in every region of the country and are located in 45 states plus the District of Columbia. Only Idaho, Nevada, North and South Dakota, and Wyoming report no school-based health center. (Figure 1)
Which states lead the way?
In 1998, the states with the largest number of centers included: New York (158), Arizona (82), Texas (77), Florida (64), California (64), Connecticut (51), Maryland (43), Michigan (41), New Mexico (40), Oregon (39), and North Carolina (39).
Which regions host the largest number?
Mid-Atlantic and New England states continue to lead the regions with 37% of the total. However, the Southwestern/Rocky Mountain states and the Midwest, which house 20% and 15% of the total respectively, have seen the largest growth in the past two years. Eighteen percent are located in Southeast/South-central states, and 10% are found in the Pacific states.
Rural or Urban?
School-based health centers are located in urban, rural, and suburban communities, with the largest recent increases in rural areas. (Figure 2)
What types of schools house school-based health centers?
They are in elementary schools (33%), middle schools (16%), high schools (38%), K-12 schools (6%), and a mix of other schools (7%). (Figure 3)
How long are they open?
In 57% of the centers, medical services are available more than 25 hours per week; 43% of centers offer medical services less than 25 hours per week. (Figure 3)
What kinds of services do they provide?The services offered at each center are determined by each community in conformity with state laws. Surveys of students, parents and school staff frequently are used to assess student needs. While no nationwide data are available to describe all services provided by the 1157 centers, two recent reports suggest the breadth of services:
How are they staffed?
Nurses and health educators who provide preventive and health promotion services are on site most frequently (averaging 34 hours per week), according to a 1998 national survey of 621 school-based health centers. Next in line are primary care providers — physicians, nurse practitioners and physician assistants (about 25 hours per week). Mental health and substance abuse treatment professionals follow, and include clinical social workers, psychologists, and psychiatrists as well as other licensed mental health providers (nearly 19 hours per week). The survey was conducted by the National Assembly on School-based Health Care (NASBHC). (Figure 6)
Which institution sponsor the centers?
All school-based health centers are sponsored by a larger agency. Data from the same NASBHC survey reveal the following leading sponsors: