School-based health services and educational attainment

February 24, 2019

School-based health centers provide students with comprehensive, convenient primary health care, and some evidence indicates that they also contribute to academic achievement among adolescents.

However, very little research has investigated possible long-term effects of specific types of school-based health services (SBHS) on educational attainment in adulthood.

A new article from the Prevention Research Center of the Pacific Institute for Research and Evaluation examines relationships between availability and use of school-based health centers among adolescents and educational attainment in adulthood.

Data from the National Longitudinal Study of Adolescent to Adult Health were analyzed to assess relationships among different types of SBHS provided by schools, such as immunizations, physical exams, family planning counseling, and emotional counseling, and use of SBHS among adolescents in 1995, and educational attainment in young adulthood (2001?02) and later adulthood (2008).

The results show that, at the school level, providing immunizations in 1995 was associated with higher educational attainment in 2001-02 and 2008. Providing physical exams and physical fitness/recreation centers also were marginally associated with higher educational attainment in 2001-02 and 2008, respectively.

At the individual level, receiving a physical exam at school in 1995 was associated with higher educational attainment in 2001-02, and receiving emotional counseling at school was inversely associated with educational attainment in 2008.

None of the other types of SBHS at the school or individual level were associated with later educational attainment.

This study suggests that preventive SBHS such as immunizations, physical exams and physical fitness/recreation centers may contribute to academic achievement and higher educational attainment during young and later adulthood.

Says Dr. Paschall: "Although this study suggests that school-based health services may contribute to higher educational attainment, more research is needed to better understand the underlying mechanisms, and the extent to which school-based health services may help reduce disparities in adolescent health and academic achievement."
Source: Paschall, Mallie J., Melina Bersamin, Laura J. Finan, and Lei Zhang (2019). "School-based health services and educational attainment: Findings from a national longitudinal study." Preventive Medicine, 121, 74-78.

PIRE is an independent, nonprofit organization merging scientific knowledge and proven practice to create solutions that improve the health, safety and well-being of individuals, communities, and nations around the world.

The Prevention Research Center (PRC) of PIRE is one of 16 centers sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), of the National Institutes of Health, and is the only one that specializes in prevention. PRC's focus is on conducting research to better understand the social and physical environments that influence individual behavior that lead to alcohol and drug misuse.

The Resource Link for Community Action provides information and practical guidance to state and community agencies and organizations, policy makers, and members of the public who are interested in combating alcohol and other drug abuse and misuse.

If you would like more information about this topic, please call Sue Thomas at 831.429.4084 or email her at

Pacific Institute for Research and Evaluation

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