The Changing Landscape of School-Based Health Centers and Other School-Based Clinics in California, 2011-2023.
Katherine M Rancaño, Ashley M Kranz, Jessica Richard and 3 others
PMID 41748135WHAT IT FOUND
School-based clinics in California expanded significantly between 2011 and 2023, with mental health services driving growth in non-medical clinics.
Access remains concentrated in urban, high-need schools, leaving rural and elementary students with fewer options.
Key findings
01The number of school-based health centers (SBHCs) grew by 50%, while other school-based clinics (OSBCs), which provide mental, dental, or reproductive care but no medical care, grew by nearly 500%.
02In 2023, schools with higher shares of English Learner students and those located in large cities were significantly more likely to have access to these clinics.
03Elementary schools were significantly less likely to have access to either type of clinic compared to high schools.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot determine why schools gained or lost access or prove causality. Data on clinics relies on voluntary reporting, which may miss some centers or misclassify services. The study did not include data on individual student visits, so it cannot show how often students actually used these services or what specific care they received. Findings are specific to California and may not generalize to other states with different funding or policy landscapes.
Declared interests
The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that the growth in clinics means equitable access. The data shows these services are still heavily concentrated in urban high schools, leaving rural areas and younger children with significantly fewer options.