A Quantitative Comparison of the Effects of State Policies on the Number, Quality, and Accessibility of School-Based Health Centers in 28 American States

Abstract

School-Based Health Centers (SBHCs) are a cost-effective way to increase access to and utilization of health care while improving academic performance. However, despite their demonstrated benefits, they are present in only 2% of public schools in the United States. (Larson & Chapman, 2014) To examine the potential effect of state policies on the number and quality of SBHCs, exploratory analyses and a two-level linear regression analysis were conducted. The exploratory analyses demonstrated that, as expected, funding and state politics have an effect on the number of SBHCs. However, these alone cannot explain inter-state variation and therefore state policies may be a potential additional explanatory factor. State policies did have a positive correlation with the number of SBHCs, but none of the policies had a significant effect (p>0.05) on SBHC quality, as measured by services provided, when analyzed via a two-level linear regression. The results of this study are limited by an untested theoretical basis for the dependent variable, as well as a limited sample size secondary to missing data.