Health and Academics are Intertwined
Health problems and risk-taking behaviors are linked to poor student achievement. Conversely, low academic achievement is a powerful predictor of risk-taking behavior and compromised health status. Student achievement, attendance, and dropout are major concerns of educators, policymakers, and parents alike, and poor health severely limits a child’s motivation and ability to learn.
A large body of evidence supports a connection between students’ health status and academic performance.1 Research has found that vision, oral health, asthma, teen pregnancy, aggression and violence, physical activity, nutrition, substance use, and inattention and hyperactivity are key health problems that impede academic success by reducing student’s motivation and ability to learn.2, 3, 4
SBHCs are Ideally Positioned to Support Student Success
School-based health centers (SBHCs) provide an optimal setting to foster learning readiness and academic achievement while giving children the resources they need to improve their health. Over the past two decades, there have been several published research studies on the link between SBHCs and academic indicators of success, including attendance, early dismissal from school, school dropout, and grades.5, 6 Key findings include:
- An early study conducted in a northeast city with a largely Hispanic immigrant population found that screening for mental health issues and referrals to appropriate services significantly reduced school absences and tardiness.7
- A multi-site evaluation of elementary schools in the Bronx, New York, compared students attending schools with and without SBHCs. Access to SBHCs was associated with a significant reduction in the rate of hospitalization and a gain of three days of school for students with asthma.8
- A study of Seattle 9th grade students found that SBHC use was significantly associated with improved attendance, particularly among those students who used medical services. This study also found that SBHC use was significantly associated with grade point average gains, particularly among mental health counseling users. The authors caution that these impacts were limited to higher risk youth and effect sizes were relatively small.9
- Another study in two urban high schools in western New York found that students with access to an SBHC were significantly less likely to be sent home during the school day than those who did not have access. The author concluded that SBHCs were able to increase student learning, also called “seat time.”10
There is very limited research on the connection between SBHCs and school dropout. One recent study of an urban public school district linked school district data with SBHC utilization data and found no impact on dropout rates for SBHC users and a group of non-users who were statistically controlled for dropout risk.11, 12 Further research on this topic is warranted.
California School-Based Health Alliance
A large body of evidence supports a connection between students’ health status and academic performance. This guide from the California School-Based Health Alliance provides strategies that school-based health center partners can use to document the links between their health care efforts and academic indicators. These strategies are presented in order from low-cost methods that are easy to implement to more costly, labor-intensive methods.
Federal Education Policy
This paper by Jeanita Richardson provides a research-based overview of prevailing demands on schools, focusing primarily on the governance and funding policies of public K-12 schools at the federal level.
Centers for Disease Control and Prevention’s Division of Adolescent and School Health
CDC’s Division of Adolescent and School Health provides a number of resources on the link between health and academics, including their guide on health and academic achievement and their Whole School, Whole Community, Whole Child Initiative.
(1) Basch C. Healthier Students Are Better Learners: A Missing Link in School Reforms to Close the Achievement Gap. New York: Campaign for Educational Equity Teachers College, Columbia University; 2010.
(2) Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Preventing Chronic Disease. Oct 2007;4(4):A107.
(3) Guarnizo-Herreño CC, Wehby GL. Children’s dental health, school performance, and psychosocial well-being. The Journal of Pediatrics. 2012;161(6):1153-1159. e1152.
(4) Bradley BJ, Greene AC. Do health and education agencies in the United States share responsibility for academic achievement and health? A review of 25 years of evidence about the relationship of adolescents’ academic achievement and health behaviors. Journal of Adolescent Health. 2013;52(5):523-532.
(5) Geierstanger SP, Amaral G, Mansour M, Walters SR. School-Based Health Centers and Academic Performance: Research, Challenges, and Recommendations. Journal of School Health. Nov 2004;74(9):347-352.
(6) Soleimanpour S, Geierstanger S. (2015). Documenting the Link between School-Based Health Centers and Academic Success: A Guide for the Field. California School-Based Health Alliance.
(7) Gall G, Pagano ME, Desmond MS, Perrin JM, Murphy JM. Utility of Psychosocial Screening at a School-Based Health Center. Journal of School Health. Sep 2000;70(7):292-298.
(8) Webber MP, Carpiniello KE, Oruwariye T, Lo Y, Burton WB, Appel DK. Burden of Asthma in Inner-City Elementary School Children: Do School-Based Health Centers Make a Difference? Archives of Pediatrics & Adolescent Medicine. Feb 2003;157(2):125-129.
(9) Walker SC, Kerns SE, Lyon AR, Bruns EJ, Cosgrove TJ. Impact of School-Based Health Center use on academic outcomes. The Journal of Adolescent Health. Mar 2010;46(3):251-257.
(10) Van Cura M. The relationship between school-based health centers, rates of early dismissal from school, and loss of seat time. Journal of School Health. Aug 2010;80(8):371-377.
(11) Kisker EE, Brown RS. Do school-based health centers improve adolescents’ access to health care, health status, and risk-taking behavior? The Journal of Adolescent Health. May 1996;18(5):335-343.
(12) Kerns SE, Pullmann MD, Walker SC, Lyon AR, Cosgrove TJ, Bruns EJ. Adolescent use of school-based health centers and high school dropout. Archives of Pediatrics & Adolescent Medicine. Jul 2011;165(7):617-623.
(13) Kerns, S. E. U., Pullmann, M. D., Walker, S. C., Lyon, A. R., Cosgrove, T. J., & Bruns, E. J. (2012). Adolescent use of school-based health centers and high school dropout rates–reply. Archives of Pediatrics and Adolescent Medicine. 166(7), 675-677.