Children with chronic health concerns can’t learn when their poorly managed conditions keep them out of class. Students traumatized by unstable living conditions or chronic disadvantage can’t focus on homework or engage their peers. Parents working full-time jobs for minimum wage cannot afford the same extracurricular, health, and academic supports that wealthier families purchase to help their children get ahead. Every year, more research supports the common-sense notion that academic success is inextricably linked to a child’s health, housing, and family income—and underscores the urgent need for more support.
The solution is clear: Organize the various supports that children and their families need and deliver them through an accessible, centralized system, one ideally based on school property.
The Schott Foundation for Public Education shed further light on the connection between cross-sector supports and educational outcomes in its Loving Cities Index released last year. Schott researchers used data from 10 cities to identify the successes and barriers that currently exist for children to thrive. The index measured levels of access to 24 critical supports—including access to healthy food, affordable housing, sustainable wages, and public transportation—proven to be connected to educational outcomes. The researchers assessed cities on access gaps by race to ensure the measures fully accounted for racial inequity.
The results were discouraging. The cities—which spanned from Buffalo, N.Y., to Little Rock, Ark., to Long Beach, Calif.—had only between one-third to one-half of the supports needed to provide healthy living and learning environments for their children. Yet, the solution is clear: Organize the various services that children and their families need, and deliver them through an accessible, centralized system that is ideally based on school property.
It’s an idea that’s flourished since the 1970s when public-health pioneers in St. Paul, Minn.; Cambridge, Mass.; and Dallas began piloting the nation’s first school-based health centers as a way to administer health care to children from birth to age 18. By the time the first official census of school-based health centers was conducted by the Center for Population Options in 1985, 31 school clinics had sprouted up across 18 cities. Today, there are nearly 3,000 school-based access points serving a staggering 6.3 million students on 10,000 school campuses, according to the 2016-17 National School-Based Health Care Census. Research shows that school-based health centers powerfully (and cost-effectively) expand health-care access and support academic achievement.
The School-Based Health Alliance has collected data for two decades on this model, and in the process we’ve learned a great deal about the conditions necessary for school health centers to foster vibrant, healthy communities:
1. Community coalitions and testimony should focus on building crucial support at the state and local levels.
While attention is often placed on federal policies, we’ve learned that local and state elected officials actually hold more power to implement support systems for children. They’re also more likely to work across party lines than national politicians, as they can more directly hear from constituents whose lives are bettered by the model.
2. Sustainable funding policies are necessary for real success.
The financial model of school-based health varies by community, but the basic building blocks for sustainable programs involve a creative blending of insurance reimbursement (both Medicaid and commercial insurers), public and private grants from federal, state, and local governments, and in-kind community support.
3. Collaborating with partners is essential.
When the integration of health and education partners is seamless—meaning one is not a “guest” in the other’s space—great things happen. School attendance improves, chronic conditions are better managed, and behavioral conditions get quick, expert attention. A good health partner understands the culture of education and sees its contributions primarily through the lens of academic success: keeping students in their seats and learning.
We envision a day, and soon, when every young person in America—whatever their ZIP code—has nutritious food and safe drinking water, secure and affordable housing, opportunities for play and recreation, and safe routes to school. We want their schools to be places where they can get treated for chronic physical and mental-health conditions and access medical, behavioral, and oral-health services. We want their school climate and discipline policies to draw on positive, effective techniques like restorative justice, instead of suspension and expulsion.
It’s time we transformed our academic institutions into vibrant hubs that focus on a child’s whole well-being—body, mind, and spirit. School-community health-care partnerships have demonstrated their capacity to deliver on that vision.
