The Changing Landscape of School-Based Health Centers and Other School-Based Clinics in California, 2011-2023

School-based health centers (SBHCs) and other school-based clinics (OSBCs) reduce health care access barriers and support positive outcomes in disadvantaged children by providing primary medical care and other services, respectively. This study describes California SBHCs and OSBCs and identifies school characteristics associated with access.

Databases on California SBHCs, OSBCs, and schools were compiled. Descriptive statistics characterize the number of clinics and services offered from 2011 to 2023. Multivariable logistic regression models estimate associations between school characteristics and SBHC/OSBC access in 2023.

Between 2011and 2023, the SBHCs increased from 124 to 186, and services became more comprehensive. OSBCs increased from 18 to 104, with most offering mental health services. SBHC access was more likely in schools with a larger share of students who were English Learners and "other" as their race and ethnicity; high schools; and in large cities. OSBC access was more likely in schools with a larger share of English Learner students and in cities.

SBHCs and OSBCs expanded and largely served disadvantaged schools, which may promote health and academic equity.