Evidence-Based Impact

Study 1: SBHCs and Absenteeism in Rural Schools

School-Based Health Centers and School Attendance in Rural Areas – PMC

Cross-sectional study of 66,303 K–12 students in rural communities
Students without SBHC access were more likely to be:
- Chronically absent
- At risk for chronic absenteeism
After adjusting for confounding variables (grade level, sex, school year, economic disadvantage, community wealth, district size):
- Students in SBHC districts had 12% greater odds of being classified as not at risk for chronic absenteeism
Strongest effects observed:
- Among elementary school students
- At lower levels of absenteeism
Suggests early access to school-based primary care:
- Prevents attendance issues from escalating
- Supports educational continuity in rural settings

School-Based Health Centers to Advance Health Equity – PubMed

Children from low-income and minority populations:
- Less likely to have consistent medical care
- More likely to experience chronic health conditions, stress, food insecurity, untreated vision/hearing problems

Systematic review of 46 studies on SBHCs found associations with:

Improved Academic Outcomes

Improved Health Outcomes

Conclusion:

Public Cost Study Report

SBHCs increase access to:
- Mental health services
- Dental care
Mental health services:
- Account for ~30% of healthcare costs for school-age children
- Increased by 5–7% after SBHC implementation
Outcomes associated with increased services:
- Decreased asthma-related hospitalizations
- Lower prescription drug utilization
- Reduced emergency and crisis care usage
Medicaid spending:
- Did not significantly increase
- Shifted toward preventive and outpatient care

Economic Impact (4 SBHCs studied over 3 years):

Total benefits: $2.5M–$6.6M, the total financial value created by having the health centers (Fewer ER visits, parents miss less work, better managed chronic illnesses)
Net social benefits: $553,553–$4.6M generated. These centers generate a greater financial benefit than cost to operate (accounting for costs such as facilities, staffing, and supplies).
The program produced more financial benefit than it cost to run

Additional benefits:

Conclusion:

School-Based Health Centers, Depression, and Suicide Risk Among Adolescents – PubMed

Examined 168 Oregon public schools (2013 & 2015)
- 25 had SBHCs
- 14 expanded mental health services
Students in SBHC schools that expanded services were significantly less likely to report:
- Students were about 12% less likely to report depression.
- Students were about 16% less likely to report suicidal thoughts.
- Students were about 18% less likely to attempt suicide.
Additional reductions seen when compared specifically to SBHC schools that did not expand services
No significant differences across demographic subgroups:
- Suggesting broad impact across populations

Conclusion:

Increased school-based mental health access is associated with measurable reductions in adolescent depression and suicide risk