School-based health care for urban minority junior high school students

OBJECTIVE: To describe the use of school-based health clinics by urban minority junior high school students. DESIGN: Review of demographic and utilization data collected by service providers during clinic visits. SETTINGS AND PARTICIPANTS: Health clinics in four junior high schools that enrolled predominantly Hispanic students who were residing in an economically disadvantaged, medically underserved New York (NY) school district. RESULTS: Of 5757 students who were enrolled in the schools, 5296 (92%) obtained parental consent to use the clinics, and 3723 (65%) used the clinics during the 1991-1992 academic year. Clinic users were 11 to 15 years old, 50% male and 50% female, 81% Hispanic and 14% black, and 29% sixth graders, 33% seventh graders, and 38% eighth graders. Clinic users made 16,340 clinic visits during the 1991-1992 academic year. Presenting complaints were mental health problems (32%), illness (14%), injury (12%), physical examination (5%), immunization (3%), follow-up (21%), and other (13%). Referral sources were clinic outreach (48%), self (44%), and school personnel (8%). Disposition of visits was on-site treatment (92%), referral to an affiliated hospital (5%), and referral elsewhere (3%). Compared with a nationwide group of high school-based clinics that served predominantly black adolescents, these clinics provided more mental health care (31% vs 21%), similar illness/injury care (32% vs 30%), and less preventive (10% vs 24%) and reproductive/contraceptive (7% vs 12%) care. CONCLUSIONS: Junior high school-based clinics can provide a wide range of primary and preventive health care services for large numbers of medically underserved youths. The provision of mental health services may fill a critical need among inner-city adolescents. Clinic outreach may be necessary to maximize utilization, especially among high-risk students.