Inequalities in health and academic outcomes persist for children from low-income families. School-based health centers (SBHCs), in-school clinics operated by outside providers that provide healthcare directly to students, may improve these outcomes by lowering barriers to care such as transportation, time, and financial cost. In partnership with the New York City Office of School Health, this study will provide causal evidence on whether SBHCs reduce inequalities, and which aspects of SBHCs matter most. The team will use school administrative data on the entire population of NYC public-school children (ages 5-17) from 2006–2028, including about 1 million students per year, of whom 75% are living below 185% of the federal poverty level, and about 200,000 are enrolled in one of 400 SBHC schools. To estimate student-level effects on health and education outcomes, the team will use quasi-experimental methods that exploit the natural experiments created by the opening of SBHCs in new schools during the study period and by the random and quasi-random assignment of children to schools through the school choice system. They will also use regression models to explore how SBHC features, such as the range of care offered or enrollment percentage, are related to their effectiveness. Findings will provide evidence on whether SBHCs improve youth outcomes and, if so, what features are most important. Findings will also directly inform NYC school health programs.
Do school-based health centers (SBHCs) reduce inequalities in health and education outcomes for children from low-income families compared to children from higher-income families?
