School-Based Health Clinics

In this chapter, Paul Brodeur, a former staff writer for the New Yorker who specializes in environmental and health issues, tells the story of the Foundation's 25-year-plus involvement in school-based health clinics. These clinics bring a wide range of health care services to students in the place where they spend most of their days—the school building.

Schools are a logical place to provide care and referrals for young people because of their convenient location and because students feel more comfortable seeking health care advice—especially mental health counseling—from people there. Moreover, health education efforts can be directly targeted to meet the needs of students, and teachers who observe health problems in students can refer them to an in-house health professional. It is not surprising, therefore, that health clinics are now found in many schools throughout the country. According to a recent report, there are more than 1,100 school-based health clinics in the United States.

Despite their growing acceptance, school-based clinics can be controversial. The interest of some clinics in providing counseling about safe sex or distributing birth control methods sparked early resistance in some communities. Brodeur looks at the opposition in Dade County, Fla., and in San Fernando, Calif., and how, eventually, it was overcome. Ironically (and sadly), an evaluation of the School-Based Adolescent Health Care Program found that the clinics were successful in spreading awareness about health issues and risky behaviors, but this knowledge did not translate into less-risky behaviors nor did it affect sexual activity.

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