School-Based Health Centers to Advance Health Equity: A Community Guide Systematic Review.
Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing-obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity.



A systematic literature search was conducted for papers published through July 2014. Using Community Guide systematic review methods, reviewers identified, abstracted, and summarized available evidence of the effectiveness of SBHCs on educational and health-related outcomes. Analyses were conducted in 2014-2015.



Most of the 46 studies included in the review evaluated onsite clinics serving urban, low-income, and racial or ethnic minority high school students. The presence and use of SBHCs were associated with improved educational (i.e., grade point average, grade promotion, suspension, and non-completion rates) and health-related outcomes (i.e., vaccination and other preventive services, asthma morbidity, emergency department use and hospital admissions, contraceptive use among females, prenatal care, birth weight, illegal substance use, and alcohol consumption). More services and more hours of availability were associated with greater reductions in emergency department overuse.



Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity.
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia.
John A
JA
Knopf
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia.
Ramona K C
RK
Finnie
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia.
Yinan
Y
Peng
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia. Electronic address: rhahn@cdc.gov.
Robert A
RA
Hahn
Office of the Associate Director for Science, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), CDC, Atlanta, Georgia.
Benedict I
BI
Truman
NCHHSTP, CDC, Atlanta, Georgia.
Mary
M
Vernon-Smiley
Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia.
Veda C
VC
Johnson
Rutgers New Jersey Medical School, Newark, New Jersey.
Robert L
RL
Johnson
UCLA Fielding School of Public Health, Los Angeles, California.
Jonathan E
JE
Fielding
University of Toronto, Bloomberg Faculty of Nursing, Toronto, Ontario, Canada.
Carles
C
Muntaner
NCHHSTP, CDC, Atlanta, Georgia.
Pete C
PC
Hunt
Satcher Health Leadership Institute at the Morehouse School of Medicine, Atlanta, Georgia.
Camara
C
Phyllis Jones
Columbia University Mailman School of Public Health, New York, New York.
Mindy T
MT
Fullilove
D004522:Educational Status; D000069576:Health Equity; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008913:Minority Groups; D017063:Outcome Assessment, Health Care; D011203:Poverty; D012572:School Health Services / Q000458:organization & administration*