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Editorial: School-based health care a worthy investment

Tue., Sept. 7, 2010

Baby boomers often have vivid memories of the school nurse’s office of their childhood. A woman in a white, starched cap poised near a pristine cot, ready to administer a shot or apply a Band-Aid at any hour.

School funding cuts have dramatically changed the role of the school nurse. In Spokane Public Schools, nurses now work in teams to cover as many as eight different schools apiece. The schools employ approximately one nurse to every 2,200 students.

That’s why news last week of a $50,000 Gates Foundation grant to research school-based health centers in Spokane appeared promising. The nonprofit group, Communities in Schools of Spokane County, will use the funds to collaborate with the Spokane Regional Health District, local school districts and community health organizations. An advisory committee will study effective models and devise a plan for pilot and long-term funding.

More than 1,700 school-based health clinics exist throughout the United States, including 14 in Seattle. According to Ben Stuckart, director of Communities in Schools of Spokane County, Spokane is one of the few metropolitan areas of its size without one.

The scope of these clinics varies, but they’re often designed to bring greater access to medical and mental health care to students who attend high-poverty schools.

In 2008 the Washington State Healthy Youth Survey found that 44.2 percent of Spokane County youths had not seen a health care provider for a check-up in the past 12 months.

Struggling working families may lack both time and transportation. A single mother working two jobs and relying on public buses may forgo important doctor’s visits. A child who needs a strep test, for example, may be more likely to receive that care if the clinic is located at school.

According to Kathe Reed-McKay, health services director for Spokane Public Schools, school nurses now focus on meeting the needs of children with serious and chronic health problems. As rates of diabetes have risen and the treatment for the disease has changed, nurses now need to help administer insulin to more children throughout the day. They oversee treatment for asthma, food allergies and seizure disorders, as well as other serious illnesses.

Elsewhere, research has shown that school-based health clinics can improve academic performance. A study reported by the Journal of Adolescent Health last year concluded that school attendance and grade point averages increased for students receiving care in school clinics.

Funding for school-based clinics could come from state and local foundations, government, hospitals and local health care volunteers. The new federal health care reform law includes funds for capital expenses related to school-based clinics. Communities in Schools has set fall 2011 as a target date for opening at least one clinic here.

The days of a school nurse assigned to every classroom building have disappeared right along with those stiff white caps. But this new idea could keep a significant number of Spokane students healthier and much more ready to learn.