Related Experiment Video
Updated: Aug 5, 2026
Bridging the Technology Divide in the COVID-19 Era: Using Virtual Outreach to Expose Middle and High School Students to Imaging Technology
Published on: September 28, 2022
The role of school-based health centers in mitigating insurance-based disparities in rural preventive care
Xue Zhang1, Wendy M Brunner2, Chris Kjolhede3
1Department of Biobehavioral Health, Penn State University, University Park, PA, USA.
Objective:
This study examines whether school-based health center (SBHC) access mitigates insurance-based disparities in preventive care utilization, including well-child visits and influenza (flu) vaccination, among students with primary care visits in a rural region of New York State.
Methods:
Using 2024 electronic health records from a regional healthcare network, we analyzed 15,267 students aged 5-18. Students were categorized by SBHC access and insurance type (Medicaid vs. commercial). Logistic regressions estimated preventive care utilization by SBHC access and insurance type, with marginal effects examining their interaction. Among students with SBHC access, visits were stratified by care site to examine the odds of SBHC and non-SBHC visits by insurance type. Models were adjusted for age, sex, community socioeconomic status, and district random effects.
Results:
Overall, 53% of students had SBHC access, and 56% were Medicaid insured. Students with SBHC access and commercial insurance had the highest preventive care utilization, while Medicaid-insured students without SBHC access had the lowest. Insurance-based disparities were observed in well-child visits, and were not fully mitigated by SBHC access. However, Medicaid-insured students with SBHC access had higher utilization of well-child visits and flu vaccination than those without access, and had similar odds of well-child visits as commercially-insured students without SBHC access. Among students with SBHC access, well-child visits delivered in SBHCs showed no insurance-based disparities.
Conclusions:
Among students using primary care, insurance-based disparities were found in well-child visits. Although SBHCs did not fully eliminate insurance-based disparities, they improved preventive care utilization among Medicaid-insured students in rural areas.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Preventive Healthcare Services
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...