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School-based health centers : ウィキペディア英語版
School-based health centers

School-based health centers (SBHCs) 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.
==History==

In 1894, New York City officials initiated the first school health program in the U.S.〔Stern, A. M., Reilly, M. B., Cetron, M. S., & Markel, H. (2010). "Better off in school": School medical inspection as a public health strategy during the 1918-119 influenza pandemic in the United States. ''Public Health Reports, 125 (S3),'' 63-79.〕 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.〔Porter, P. J., Avery, E. H. & Fellows, J. A. (1974). Model for the reorganization of child health services within an urban community. ''American Journal of Public Health, 64,'' 618-619.〕 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).〔Lear, J. G., Gleicher, H. B., St. Germaine, A., & Porter, P. J. (1991). Reorganizing health care for adolescents: The experience of the school-based adolescent health care program. ''Journal of Adolescent Health, 12,'' 450-458.〕 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.〔Lear, J. G. (1996). School-based services and adolescent health: Past, present and future. ''Adolescent Medicine, 7,'' 163-180.〕 These early centers demonstrated that they were effective in increasing young people’s access to care.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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