page_title: School-based health centers
section_title: History
hierarchical_section_title: School-based health centers / History
caption_attribution_description: English: A chart displaying the growth in school-based health centers across the U.S., from 1984 to 2008.
context_page_description: School-based health centers are primary care clinics based on primary and secondary school campuses in the United States.
  Most SBHCs provide a combination of primary care, mental health care, substance abuse counseling, case management, dental health, nutrition education, health education and health promotion. An emphasis is placed on prevention and early intervention. School-based health centers generally operate as a partnership between the school district and a community health organization, such as a community health center, hospital, or the local health department. Most SBHCs report that the majority of their student population is eligible for the National School Lunch program, a common indicator of low socioeconomic status.
context_section_description: In 1894, New York City officials initiated the first school health program in the U.S. Its purpose was to assess and, if needed, exclude children with contagious diseases from the classroom. In 1902, the program expanded and employed the nation’s first school nurse. As school health programs spread across the country, health screening and communicable disease control were their principal focus.
  President Lyndon Johnson’s War on Poverty in the mid-1960s is credited with bringing into focus the significance of health issues among impoverished school-age children.  The enactment of Medicaid in 1965 was indicative of a perception in the public policy community that there was a need to develop programs in service of better health care for low-income individuals, including children.
  In 1967, Philip J. Porter, head of pediatrics at Cambridge City Hospital in Massachusetts and director of Maternal and Child Health for the city's health department, began to address this issue.  He assigned a nurse practitioner to work on site in an elementary school to deliver primary medical care to enrollees. Four additional health clinics were opened in Cambridge schools in the years that followed.
  The first school-based health centers opened in Cambridge, Massachusetts (1967), Dallas, Texas (1970), and St. Paul, Minnesota (1973).  The first two were launched because their founders believed that school-based health care could provide accessible, affordable health care to poor children. In 1970, the West Dallas Youth Center at Pinkston High School was opened as an outreach center for a federally funded Children and Youth Program based in the University of Texas Health Sciences Center Pediatrics Department. Pinkston High School was the nation’s first high school to offer comprehensive care provided by nurse practitioners, physicians, social workers, nutritionists, and health educators. 
   In 1978, funding through the Robert Wood Johnson Foundation spurred an increase in the number of centers throughout the United States. These early centers demonstrated they were effective in increasing young people’s access to care.  The role of the pediatric nurse practitioner (PNP) as an advanced practice nurse with skills to provide primary health care to children began to emerge. With a seed grant of $7,000, the first school nurse practitioner certification program was established at the University of Colorado in the late 1960s in response to public dissatisfaction with the limited role of the school nurse and the recognized need for on-site school health.
caption: School-Based Health Center Growth in the U.S. from 1984 to 2008
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