Figure 1
Source: Current Population Reports, Series P-25, No. 311, No. 519, No. 917, No. 1130 (Table 2 in each); and unpublished data, U.S. Bureau of the Census
Figure 2
Source: Access to Health Care Part 1: Children (Vital and Health Statistics, Series 10, no. 10), 1997, National Center for Health Statistics, Centers for Disease Control, US Dept. of Health and Human Services
  • Today’s cohort of school-aged children (ages 6-17) approaches the largest ever. By 2010 it will match the record-breaking baby boom level of 1970 — more than 48 million. (Figure 1)
  • Adolescents (ages 10-19) have the lowest utilization of health care services of any age group and are the least likely to seek care at a provider’s office. (Figures 2 and 3)
  • Adolescents are less likely to have health insurance than other age groups. In 1997, 16.7% of 12-17 year-olds were uninsured. (Figure 4)
  • The leading causes of death for adolescents have changed from natural causes (illness and birth defects) to unintentional and intentional injuries.
  • Risky behaviors (e.g., substance abuse, unprotected sex, violence), are the leading threat to the health of adolescents and are increasingly responsible for the majority of deaths to adults under age 50. (Figure 5)
  • Even when young people are connected to health providers, traditional providers may have limited impact on behavior-related problems because they are less likely to have frequent contact with their patients and are less likely to practice alongside professionals trained to focus on mental health and health education issues.
  • During puberty in particular, physical and mental health issues are intertwined. Frequently, students feel most comfortable revealing emotional problems during the course of an acute care visit. These realities create compelling reasons for offering both physical and mental health services and for placing them in the same location.
  • To have an impact on the health of school-aged youth, young people need a team of health care providers working together at a convenient location where students know it is safe to talk about troubling issues and receive confidential care, when necessary.

 

 

Figure 3
Source: Access to Health Care Part 1: Children (Vital and Health Statistics, Series 10, no. 10), 1997, National Center for Health Statistics, Centers for Disease Control, US Dept. of Health and Human Services

 

Figure 4
HEALTH INSURANCE STATUS AND TYPE OF COVERAGE FOR SCHOOL-AGED CHILDREN, 1997
Age 6-11 Age 12-17

Private Insurance
68.1%
69.5%

Medicaid
20.1%
15.6%

Military
3.0%
3.1%

Uninsured
13.9%
16.7%
Source: Health Insurance Coverage: 1997, Poverty and Health Statistics Branch, Housing and Household Economic Statistics Division, US Census Bureau

Figure 5
YOUTH RISK BEHAVIOR TRENDS:
STUDENTS, GRADES 9-12, 1991, 1997
Behavior
1991
1997

Current cigarette use1
27.5%
36.4%

Current alcohol use2
50.8%
50.8%

Episodic Drinking3
31.3%
33.4%

Carried a weapon4
includes knives, clubs,guns
26.1%
18.3%

Current marijuana use5
14.7%
26.2%

Sexual intercourse:
past three months
9th grade
12th grade

37.5%
22.4%
50.6%

34.8%
24.2%
46.0%

Source: Youth Risk Behavior Survey, Centers for Disease Control, US Dept. of Health and Human Services. The survey is a national school-based survey conducted biennially to assess the prevalence of health risk behaviors among high school students1smoked cigarettes on 1 or more of the 30 days preceding the survey
2drank alcohol on 1 or more of the 30 days preceding the survey
3drank 5 or more drink in a row on at least one occasion during the 30 days preceding the survey
4at least 1 time during the 30 days preceding the survey
5at least 1 time during the 30 days preceding the survey

How do school-based health centers help? They…

Attend to unmet health needs;

  • are located where young people are, providing health care when they want it, where they need it;
  • screen to prevent and treat diseases and other health threats;
  • provide health promotion to keep students drug-free and physically fit;
  • are a safe place for young people to talk about troubling issues; and
  • complement the community health care system Support families;
  • value parental involvement in their children’s health care;
  • keep parents in the workplace;
  • strengthen the connection between school and the family; and
  • link families to a variety of needed services.Reduce barriers to learning;
  • help to keep students in school and work with school staff to remove physical and emotional barriers to learning;
  • provide counseling and support to students experiencing family and community stress;
  • identify students at risk for violence and substance abuse and intervene early to promote a safe and healthy environment;
  • respond in times of school-wide crisis; and
  • help to reduce the need for special education services.Represent wise investments;
  • help to keep children out of hospitals and emergency rooms;
  • detect illness early to help reduce the need for expensive treatment later;
  • reduce parental work absences; and
  • are excellent vehicles for attacking the risky behaviors responsible for so much of the morbidity and mortality of adolescents and adults.