Classrooms and Clinics: Urban Schools and the Protection and Promotion of Child Health, 1870-1930

By Richard A. Meckel | Go to book overview

Introduction

In the final decades of the twentieth century, American child health advocates and activist child healthcare providers rediscovered the urban public school as a potentially promising site for clinics that could deliver primary healthcare to city schoolchildren and youth. The need for such clinics had been made manifest by years of research, beginning with studies generated by the War on Poverty, demonstrating that economically disadvantaged inner-city children and youth received shockingly little basic medical and dental care or counseling and thus were very likely to have untreated conditions and defects or be at risk for developing them. Moreover, the logic behind siting such clinics in schools seemed both obvious and compelling. Schools were where the children were and thus where healthcare providers could have guaranteed access to them. Parents have to send their children to schools; they do not have to take them to private physicians’ and dentists’ offices or to public clinics. Additionally, since untreated diseases and conditions in schoolchildren were understood to contribute to absenteeism, distraction, dysfunctional behavior, and other causes of poor academic performance, it was arguable that schools had a vested interest in facilitating better healthcare for their students.1

Thus was born the school-based health center (SBHC) movement and the consequent proliferation of primary care clinics in the nation’s schools. In 1981, when SBHCs were made eligible for Maternal and Child Health Block Grant funding, there were less than a few dozen such centers. By 1990 there were 150. Today, there are an estimated 1,900 to 2,000, mostly in urban school districts but also in poor rural ones. Funded by a patchwork of federal, state, municipal, and private foundation money, they provide care for both adolescents

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