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Am J Prev Med. 2016 Jul;51(1):114-26. doi: 10.1016/j.amepre.2016.01.009.

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

Author information

1
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia.
2
Community Guide Branch, Division of Public Health Information Dissemination, CDC, Atlanta, Georgia. Electronic address: rhahn@cdc.gov.
3
Office of the Associate Director for Science, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), CDC, Atlanta, Georgia.
4
NCHHSTP, CDC, Atlanta, Georgia.
5
Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia.
6
Rutgers New Jersey Medical School, Newark, New Jersey.
7
UCLA Fielding School of Public Health, Los Angeles, California.
8
University of Toronto, Bloomberg Faculty of Nursing, Toronto, Ontario, Canada.
9
Satcher Health Leadership Institute at the Morehouse School of Medicine, Atlanta, Georgia.
10
Columbia University Mailman School of Public Health, New York, New York.

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.

PMID:
27320215
PMCID:
PMC5759331
DOI:
10.1016/j.amepre.2016.01.009
[Indexed for MEDLINE]
Free PMC Article

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