The integrated school health center: a new medical home

During the past two decades, financial access to health care has improved for the very young, with emphasis on immunizations and medical care facilities for infants and mothers. Well-woman mandates, such as cancer detection and treatment programs, have improved the health of adult women. Even efforts to meet the needs of an ever-growing elderly population have improved. In contrast to expansions and improvements in care for the aforementioned populations, among others, there is still a population whose unmet medical needs have grown exponentially: school-age youth. Morbidity and mortality for today's school-age children are linked most often to complex behavior patterns and psychosocial risk factors. Prevention and treatment of these patterns and factors often require a multidisciplinary approach using educational and case management strategies; social, mental health, dental, and nutritional services; and traditional medical services. In recognition of the school as the focus of many communities and in recognition of this population's disproportionate drain on medical expenditures, current and projected, there has been a push for more monies to be spent on developing integrated school-based and school-linked clinics. These clinics should focus on meeting community needs and should emphasize coordination and cooperation between private and public agencies. If such efforts are not continued into the 21st century, this least-served population, which on the surface seems to be the healthiest, will be a major factor in the rising cost of care, particularly because they lacked a medical home while they were school age.