University of Arkansas Office for Education Policy

School-Based Health Centers

In The View from the OEP on December 9, 2020 at 12:00 pm

Do you think School-Based Health Centers improve student attendance or academic achievement? Today OEP releases new research examining some of the intended impacts of SBHCs on public school campuses in Arkansas.  You can read the policy brief or the full paper for more details, but we wanted to share the highlights. We asked if the presence of an SBHC is associated with a change in school-level standardized achievement scores and looked descriptively at attendance trends. Results suggest that overall, Arkansas SBHCs are not associated with changes in school-level achievement scores or attendance rates.

What are School-Based Health Centers?

School-Based Health Centers (SBHC) are multi-faceted healthcare facilities serving school-age children and adolescents, their family members, and the wider community.  Arkansas’s SBHCs started in 2009 with the Arkansas SBHC Grant Program. Open to all Arkansas public schools, the grant awards schools $150,000 to open and begin operating an SBHC.  Grant funding can be renewed annually for up to five years. Currently, SBHCs are funded out of a line item in the Public School Fund. SBHCs often operate in partnership with local healthcare providers. There are several centers across the state that are not grant funded where providers have partnered with districts to implement on-campus services for students.

 Schools with SBHCs

Arkansas SBHCs provide a combination of basic physical, mental, dental or vision services. There are 40 SBHCs located on public school campuses throughout the state, located on twenty-five elementary schools, four middle schools, and eleven high schools. Average enrollment rates for the 40 schools with SBHCs is 486.  On average, 70% of students receive free and reduced lunch, and 38% of the school populations are a minority. Although there are 40 schools with SBHCs, conducting an effective before-after analysis of the relationship between SBHCs and school-level achievement scores requires the sample be reduced to 24 schools.

Do school outcomes like achievement and attendance benefit from SBHCs?

It doesn’t seem like it. Stare departments of Education and Health intend for SBHCs to impact educational outcomes by reducing absenteeism rates among staff and students and contribute to the overall improvement of academic success.  However, school-level achievement trends for the 24 schools in our analytic sample show that average school performance does not improve after an SBHC opens on the school’s campus (Figure 1). In addition, data limitations prohibit us from conducting an empirical analysis of the relationship between SBHCs and absenteeism rates for Arkansas SBHC schools, a preliminary inspection of the available attendance data suggests that the presence of an SBHC is not associated with a change in school level attendance rates (Figure 2). 

Figure 1: Average annual achievement Z-scores, by SHBC opening year cohort

Figure 2: Average annual attendance rates, by SHBC opening year cohort

What are the implications?

As the prevalence of SBHCs continues to expand across the state, it is important to understand whether these health centers are associated with improvements in school standardized achievement scores. These findings suggest SBHCs are not improving Arkansas’s school-level achievement scores, and a preliminary examination of data trends suggests SBHCs are not benefiting Arkansas school-level attendance rates either.

We do not claim that SBHCs do not benefit Arkansas public school students in other ways! In fact, given that SBHCs continue serving students and communities after the five-year renewable grant lapses, and state officials report an increase in student’s health knowledge SBHCs are benefiting students and communities across Arkansas. However, if the state persists in the expectation of SBHCs to contribute to the overall improvement in academic success, clear and measurable steps should be taken to help SBHCs and schools work toward meeting this state-wide goal.  Or perhaps it is enough to eliminate the repeated claims of SBHCs improving or contributing to education outcomes and simply declare SBHCs to be significant and essential to the school community because of other identified and mutually agreed upon reasons.

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