School-Based Health Centers Linked to Decline in Black
Teen Pregnancy
September 8, 2006, DENVER – An article in the
September issue of the American Journal of Health links
Denver’s decline in the birthrate among black adolescents in
the 1990s to the effectiveness of school-based health
centers strategically placed in schools with high numbers of
at-risk students. Authors of the article are Dr. Sue A.
Ricketts and Bruce P. Guernsey, both members of the
Prevention Services Division of the Colorado Department of
Public Health and Environment. In the article,
“School-Based Health Centers and the Decline in Black Teen
Fertility During the 1990s in Denver,” the authors compared
the declining birthrates of teens in schools with and
without school-based health centers. The authors report that
state and national teen birth rates dropped significantly,
especially among blacks and white non-Hispanic teens.
Hispanic teen birthrates were essentially flat during that
period for our state. The researchers were particularly
interested in the black teen birthrates in Colorado because
of the magnitude and speed of the decline, and because the
most dramatic drop was focused in Denver.
According to the article, the birthrate among black teens
fell the faster than any other ethnic group, by 26 percent
from 1991-1997. Additionally, Colorado’s black birthrate has
fallen faster than any state. During the same period,
1991-1997, the black teen birthrate in Colorado fell by 46
percent. Denver led the way with a decline of 50 percent,
while the rest of the state fell by only 36 percent.
Researchers at the Colorado Department of Public Health and
Environment wanted to know why. Dr. Ricketts and Guernsey
examined the decline in birthrates among black teens that
occurred in Denver between the early 1990s and 1997 and
explored the decline’s association with the hosting by
Denver schools of school-based health centers, an innovation
that had appeared in the city’s high schools by 1989.
Guernsey said school-based health centers began to appear
on the scene because of serious health risk behaviors among
teens and an emerging understanding of the many health
issues affecting them. Interventions have focused on the
school setting as a logical delivery point for comprehensive
physical and mental health care, because school is where
most children spend the greatest amount of time. He added,
“Barriers to access are reduced, and confidentiality,
compliance, early identification of risk factors, and
follow-up are increased when services are made available at
school, Guernsey said.” According to the researchers, the
rapid decline in black teen birthrates in schools with
school-based health centers occurred without providing
onsite access to birth-control methods. In an agreement with
the Denver Public Schools when the program was established,
school-based health care providers agreed not to provide
contraceptives on campus in order to sidestep controversy
that often surrounds teen sexuality. The Department of
Public Health and Environment researchers point to the
decline in the birthrate in teens in schools with health
centers as the result of program strategies to increase
access to health care: population-based health promotion and
education; aggressive identification, intervention and
follow-up with students with high risk behaviors; and
proactive use of formal referral links. Dr. Ricketts said,
“There may be advantages to providing a full range of
reproductive health services within school-based health
centers. But at least in this case we saw an impact on teen
births with more limited reproductive health services.”
The number of school-based health centers has grown
nationally from 50 in 1994 to more than 1,800 today.
Colorado has been a leader in school-based health centers.
During the same time period, the number of such health
centers in Colorado increased from 13 to 37. During its
2006 legislative session, the Colorado General Assembly
passed House Bill 06-1396, creating a new grant program to
support communities in operating school-based health
centers. Governor Bill Owens signed the legislation on June
2. The legislature appropriated $500,000 in state general
funds in fiscal year 2006-07 for grants to communities.
Funds may be used for expansion or ongoing support of
school-based health centers. Services offered in
school-based health centers that are eligible for grant
support are primary health care, behavioral health and oral
health services, and support services to increase enrollment
in the Children’s Basic Health Plan. --30-- |
