About the Data

The Children’s Health and Education Mapping Tool contains a number of indicators related to social determinants of health: high school education completion, access to free and reduced lunch,  food insecurity, and poverty status, as well as measures of health care access. The indicators that comprise the mapping tool are defined as follows:

Child Health, Education, and Socioeconomic Indicators

Health Insurance and Coverage Indicators
  • Under 19: Percent on Medicaid or CHIP: Number of children under age 19 living in families with means-tested insurance coverage divided by the number of U.S. children under age 19. National percentage is 38 percent (Source: U.S. Census Bureau, American Community Survey 2013-2017).
  • Under 19: Percent Uninsured: Number of U.S. children under age 19 who are uninsured divided by the number of U.S. children under age 19. Nationwide, 6 percent of U.S. children under 19 are uninsured (Source: U.S. Census Bureau, American Community Survey 2013-2017).
Health Indicators
  • Teen Birth Rate: Rate per 1,000 females ages 15-19 years as derived by dividing the number of births to females ages 15-19 by the number of females in the U.S. population ages 15-19. The national rate is 27 births per 1,000 women ages 15-19 (Source: RWJF, County Health Rankings and Roadmaps 2018 based on National Center for Health Statistics Natality Files, 2010-2016).
  • Percent Obese: Adult Population: Body mass index (BMI) is calculated as weight in kilograms divided by height in meters squared. Persons with a BMI of 30.0 – 99.8 kg/m2 are considered obese. Nationally, an estimated 28 percent of the adult population (ages 20 and over) is considered obese (Source: RWJF, County Health Rankings and Roadmaps 2018 based on CDC Diabetes Interactive Atlas, 2014).
  • Percent Food Insecure: Total Population: The United States Department of Agriculture (USDA) defines food insecurity as a socioeconomic condition of limited or uncertain access to enough food to support a healthy life. The national average is 13.4 percent (Source: RWJF, County Health Rankings and Roadmaps 2018 based on Map the Meal Gap, 2015).
  • Chlamydia Rate: Number of newly diagnosed chlamydia cases per 100,000 population. National average is 478.8 per 100,000 individuals (Source: RWJF, County Health Rankings and Roadmaps 2018 based on CDC Atlas 2015).
Education Indicators
  • Percent of Adults with No High School Diploma: Number of U.S. adults ages 25 and over without a high school diploma divided by the total number of U.S. adults ages 25 and over. Nationally, 13 percent of U.S. adults do not have a high school diploma (Source: U.S. Census Bureau, American Community Survey 2013-2017).
Demographic and Socioeconomic Status Indicators
  • Percent Free Lunch: Percent of total students eligible to participate in the National School Lunch Program under the Free Lunch Act as derived by dividing the number of students who are eligible for free and reduced school lunch by total school enrollment. Nationally, 52.1 percent of U.S. children are eligible for this program (Source: RWJF, County Health Rankings and Roadmaps 2018 based on National Center for Education Statistics, 2015-2016).
  • Percent Kids in Poverty: Number of U.S. children under age 18 living under the Federal Poverty Line divided by the total number of U.S. children under age 18. Nationally, 20 percent of U.S. children are living in poverty (Source: U.S. Census Bureau, American Community Survey, 2013-2017).
  • Percent Kids in Single-Parent Households: Number of U.S. children under age 18 living in single-parent households divided by the total number of U.S. children under age 18. Nationally, 33 percent of U.S. children live in single-parent households (Source: U.S. Census Bureau, American Community Survey 2013-2017).
  • Percent of Households with Severe Housing Problems: Number of households with at least one of four severe housing problems (incomplete kitchen facilities, incomplete plumbing facilities, overcrowding, and high housing costs) divided by the total number of U.S. households. The Comprehensive Housing Affordability Strategy defines overcrowding as more than one person per room and defines high housing cost as a cost burden greater than 30 percent. Nationally, 19 percent of U.S. households have severe housing problems (Source: RWJF, County Health Rankings and Roadmaps 2018 based on 2010-2014 Comprehensive Housing Affordability Strategy (CHAS) data).
  • Violent Crime Rate: Number of reported violent crime offenses, including murder and non-negligent manslaughter, forcible rape, robbery, and aggravated assault involving force or threat of force, per 100,000 population. The national average is 380 per 100,000 (Source: RWJF, County Health Rankings and Roadmaps 2018 based on 2012-2014 FBI Uniform Crime Reporting).

SBHCs and School Characteristics

Characteristics of Public Schools
  • Title I Eligibility: Title I funding provides financial assistance through state educational agencies (SEAs) to local educational agencies (LEAs) and public schools with high numbers or percentages of poor children to ensure all children meet challenging state academic content and student academic achievement standards (Source: National Center for Education Statistics, 2015-2016).
  • Lowest Grade Level Offered: Lowest grade served by school (Source: National Center for Education Statistics, 2015-2016).
  • Highest Grade Level Offered: Highest grade served by school (Source: National Center for Education Statistics, 2015-2016).
  • Free and Reduced Lunch Eligibility: Percent of students eligible for the National School Lunch Program under the Free Lunch Act (Source: National Center for Education Statistics, 2015-2016).
  • SBHCs using telehealth: View locations of traditional SBHCs where telehealth is being used to complement onsite providers and view locations of telehealth exclusive SBHCs.
Characteristics of School-Based Health Centers
  • SBHC Locations: Circles indicate where SBHCs are located. Green circles indicate SBHCs whose administrators have completed the National School-Based Health Care Census and brown circles show SBHCs that did not complete the National School-Based Health Care Census (Source: 2016-17 National SBHC Census).
  • SBHC Sponsor Organization: SBHCs can be sponsored by local health departments, Federally Qualified Health Centers, school systems, hospital/medical centers, and other organizations such as universities, tribal governments, mental health agencies, and private nonprofits (Source: 2016-17 National SBHC Census).
  • SBHC Provider Team: SBHCs have one of three staffing models:
    • Primary Care Only: This model is typically staffed by a primary care provider (nurse practitioner, physician assistant, or medical doctor) with no behavioral health provider on staff. Nevertheless, many also employ an oral health provider and/or health educator on staff.
    • Primary Care and Behavioral Health: This model is staffed by a primary care provider in partnership with a behavioral health professional, such as a licensed clinical social worker, psychologist, or substance abuse counselor.
    • Primary Care and Behavioral Health Plus Expanded Care Team: This SBHC model is the most comprehensive and employs primary care and behavioral health staff along with other provider types that complement the health care team, such as a health educator, oral health provider, and/or a nutritionist (Source: 2016-17 National SBHC Census).
  • Hours of Operation: Hours of operation vary by SBHC. Thirty-one hours per week or more is considered full-time as the average school day is six hours long (2016-17 National SBHC Census).
  • Populations Served: SBHCs serve the students in the school, and many SBHCs also provide care to other community members. SBHCs described as serving students and community members provide health care access to at least one population other than students in the school, such as students’ families, students from other schools, out-of-school youth, faculty, and members of the community (2016-17 National SBHC Census).
  • SBHC Serves Adolescents: These SBHCs serves a population that includes at least one grade of adolescents, defined by the School-Based Health Alliance as grade six or over. (2016-17 National SBHC Census).
  • Grade Levels Served: These SBHCs serve schools with grades ranging from elementary school (prekindergarten or kindergarten to five or six), middle school (six or seven to eight or nine), high school (nine or 10 to 12), all grades (prekindergarten or kindergarten through 12), and other ranges (2016-17 National SBHC Census).
  • Delivery Model: SBHCs use four delivery models (traditional, school-linked, mobile, and telehealth exclusive). These categories are determined based on the location where a patient accesses care and the location where the providers deliver care.
  • In traditional SBHCs, patients access care at a fixed site on a school campus, and providers are physically on site (although some patients also access providers using telehealth).
    • Traditional SBHCs with telehealth are fixed sites on a school campus where providers are physically onsite and accessible using telehealth.
  • In school-linked centers, patients access care at a fixed site near a school campus through formal or informal linkages with schools. Providers are physically on site and may be accessed remotely.
  • In mobile centers, patients access care at a specially equipped van or bus parked on or near a school campus. Here, too, providers are physically on site and may be accessed remotely.
  • In telehealth-exclusive centers, patients access care at a fixed site on a school campus, and providers are available remotely through telehealth for primary care services (other services such as behavioral health, oral health care, nutrition, and vision providers and/or health educators may be available physically onsite or remotely).

Basemaps and Optional Layers: Health Care Facilities and Shortage Areas

Health Care Facilities
  • Hospitals: Locations of all U.S. hospitals (Data Source: HRSA Data Warehouse).
  • Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, and other federally-funded health centers): Locations of all FQHCs and look-alikes nationwide, as well as other health centers designated as grantees of the Health Resources and Services Administration (HRSA) (Data Source: HRSA Data Warehouse).
  • Rural Health Clinics: Location of all rural health clinics. Rural health clinics are located within non-urban rural areas with health care shortage designations (Data Source: HRSA Data Warehouse).
  • SAMHSA Substance Abuse Treatment Centers: Location of behavioral health treatment centers based on the facility’s annual responses to SAMHSA surveys (Data Source: SAMHSA, 2015).
Health Policy
  • 116th U.S. Congress: Boundaries for the 116th U.S. Congress (Data Source: US Census Bureau, 2018).
  • Counties With or Without SBHCs: Designates counties with or without an SBHC(s) (Data Source: 2016-17 National SBHC Census).
  • County With FQHC, but No SBHC: Designates counties with Federally Qualified Health Centers but no SBHCs (Data Source: HRSA Geospatial Warehouse, 2018).
  • Health Professional Shortage Area (HPSA): HRSA defines HPSAs as areas with a shortage of primary care, behavioral health, and/or dental providers based on set criteria and guidelines (Data Source: HRSA Data Warehouse).
  • Medically Underserved Area (MUAs): HRSA-defined MUAs may be a whole county, a group of contiguous counties, a group of county or civil divisions, or a group of urban census tracts in which residents have a shortage of personal health services (Data Source: HRSA Data Warehouse).
State SBHC Partners
  • School-Based Health Alliance State Affiliate Organizations: State organizations that represent the school-based health care movement at the state and local level (Data Source: School-Based Health Alliance).
  • State Government Program Offices: This category comprises state governments that provide funding and/or policies and programmatic support to SBHCs (Data Source: School-Based Health Alliance).
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