RESUMEN
School-based health centers (SBHCs) provide access to health services by bringing providers to children (and sometimes parents) and furnishing low cost services in an atmosphere of trust. While the number of SBHCs has continued to grow and some clinics have continued to expand their services, others have barely survived and some have even closed. This study investigated factors, particularly political forces, that affected the success of SBHCs. Using a national survey of clinic directors, this study assessed clinic success in terms both of longevity and service delivery. Findings indicate the factors most consistently and significantly associated with success include not only measures of "need" (school size and percent African-American enrollment or population) but of "politics" (citizen political ideology and Southern conservatism). Thus, politics matters more than previous studies suggested.
Asunto(s)
Servicios de Salud Escolar , Etnicidad , Educación en Salud , Política , Atención Primaria de Salud , Servicios de Salud Escolar/economía , Servicios de Salud Escolar/organización & administración , Factores SocioeconómicosRESUMEN
This study examined both the content of school district programs related to sexual orientation, and the social and political determinants of these school programs. Data were collected from districts within all 126 U.S. communities with legal protection against discrimination on the basis of sexual orientation, and from a random sample of 129 U.S. jurisdictions without such legislation. Results showed that most school districts are not offering recommended program elements related to sexual orientation issues. Districts within localities with gay rights protection are doing more than those without. Although compositional factors account for some of the differences in educational efforts, a politically engaged constituency also made a major difference in school district efforts. To the extent that gays and lesbians served in local public office and mobilized to influence school elections, they were able to affect school programs and policies.