Politics and the success of school-based health centers

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.