Health is influenced by settings where people live, learn, work, and play. In Bexar County, Texas, 21% of children live in poverty, 62% are eligible for free/reduced-price lunch, 10% are uninsured, and reading and math scores are on average below grade level. These social determinants of health can lead to preventable health disparities, morbidity, and mortality. The school-based health program at University Health (SBHP) addresses these outcomes through a comprehensive care delivery system, innovative pilot programs, and community partnerships.

Description

The SBHP operates five brick and mortar clinics, 18 Tytocare telehealth devices, and one mobile unit in partnership with four school districts that serve over 150,000 students. More than 80% of patients served reside in neighborhoods with a social vulnerability index of 0.75 or greater. The program is staffed by a physician–medical director, nurse practitioners, physician assistants, medical assistants, licensed vocational nurses, and community outreach specialists. This team delivers primary care, mental health services, immunizations, referrals to specialty care, and connections to social workers. The mobile unit brings healthcare to neighborhoods that lack access, and Tytocare allows school nurses to facilitate a real-time, physical exam and virtually connect students and staff with SBHP clinicians.

Lessons learned

The SBHP’s population health approach, use of health information systems, community partnerships and outreach efforts, continuous quality improvement, and multi-disciplinary team can enhance academic achievement, and help achieve health equity in under-served communities.

Recommendations

Communities should invest in school-based health centers as a vehicle to address social determinants of health and mitigate health disparities.