School-Based Health Centers to Advance Health Equity A Community Guide Systematic Review

• Type of Material: Article
• Authors: John A. Knopf, Centers for Disease Control; Ramona K.C. Finnie, Centers for Disease Control; Yinan Peng, Centers for Disease Control; Robert A. Hahn, Centers for Disease Control; Benedict I. Truman, Centers for Disease Control; Mary Vernon-Smiley, Centers for Disease Control; Veda C Johnson, Emory University; Jonathan E. Fielding, University of California Los Angeles; Carles Muntaner, University of Toronto; Pete C. Hunt, Centers for Disease Control; Camara Phyllis Jones, Morehouse School of Medicine; Mindy T. Fullilove, Columbia University
• Language: English
• Date: 2016-07-01
• Publisher: Elsevier Masson
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 American Journal of Preventive Medicine.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.amepre.2016.01.009
• Title of Journal or Parent Work: American Journal of Preventive Medicine
• ISSN: 0749-3797
• Volume: 51
• Issue: 1
• Start Page: 114
• End Page: 126
• Grant/Funding Information: The work of John A. Knopf and Ramona K.C. Finnie was supported with funds from the Oak Ridge Institute for Science and Education.
• Keywords: MIDDLE SCHOOL; Science & Technology; PREVENTIVE-SERVICES; MENTAL-HEALTH; ACCESS; STUDENTS; General & Internal Medicine; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; PRENATAL-CARE; UNITED-STATES; QUALITY IMPROVEMENT; Medicine, General & Internal; ACADEMIC-ACHIEVEMENT; ADOLESCENT HEALTH
• Research Categories: Health Sciences, Public Health

Abstract

Context: 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. Evidence acquisition: 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. Evidence synthesis: 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. Conclusions: Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity.