School-Based Health Services Are the Foundation of Brighter Futures

All children deserve to be healthy and get the care they need to thrive throughout childhood and into adulthood. Student physical and mental health and wellness are critical foundations for success in school and life, but according to the 2019-2020 National Survey of Children’s Health, an estimated 69,000 school-age children in Ohio were not able to access needed health care.

In Ohio, an effort is under way to address these needs. For the past several months, representatives of more than 70 organizations across the health and education spectrum have come together to draft recommendations on how to make school health care programs financially sustainable. The Statewide Workgroup on Financial Sustainability in School Health intends the recommendations to serve as a starting point for an intentional and thoughtful conversation with state agencies about school health and the role Ohio can play.

Data is now coming forward from the last two years that highlights the growing need. The Brookings Institution recently issued a two-year analysis of the effects of COVID-19 on student learning across three school years using data from 5.4 million US students in grades 3-8.  They found that average math score dropped by as many as 0.27 standard deviations while average reading scores dropped by as many as 0.18 standard deviations. Those are dramatic declines — in the case of math scores, greater than the drop experienced by children who were evacuated from New Orleans amid Hurricane Katrina.

Physical and mental health concerns are growing as well. In a review of 82 studies that looked at physical activity in children under 18 before and after the pandemic, there was a decrease in physical activity ranging from 10 minutes to an hour and a half per day. Another review of 102 studies through mid-2021 showed significant increases in addictive behavior, problematic internet use, depression, anxiety, lack of sleep and suicidal ideation.

Providing health care in schools is one of the best ways to ensure that children are healthy and ready to learn. Increasing access to school health services is a proven strategy for improving quality of care and reducing overall health care costs. Significant limitations in the current system on who can access care, what services are available, and how services are reimbursed mean that not all students have the same access to these needed opportunities. Addressing the needs of students in this regard might seem overwhelming to tackle but there are solutions to the challenges in doing such work.

Avenues include measuring the activity and effectiveness of managed care organizations in meeting the needs of children; providing funds for student wellness  in the state school funding plan; and allocating $25.9 million in America Rescue Plan Act (Coronavirus relief) funding to create 29 new school-based health centers and expand services in an additional 107 existing centers in 2022.

For all of this work to be meaningful, there must be long-term financial sustainability for all school health services so schools and community partners can expand their reach. Expanding equitable access to physical and mental health services through community connected, school-based health care (working with community-based providers and with school health staff) reduces barriers to educational attainment and employment later in life, helps narrow health inequities, and increases access to quality health care for the whole community.

Effective, integrated school-based health services rely on cooperation among all the various actors in the space. It can be challenging to seamlessly integrate the complex requirements of the health and education systems, and this highlights the need for collaborative, long-term solutions that support sustainability for both the school and health care partners. The need is great, and there is a role for everyone. If your organization is interested in joining the conversation and adding your voice on this critical topic, please email me at nikki@advocacyandcommunication.org

As Senior Strategist for Advocacy & Communication Solutions, Nikki directs and supports strategic communication planning, government relations and advocacy efforts, policy analysis, and strategy development for clients.