Comparison of health status of children using a school-based health center for comprehensive care

Abstract

Objective: Our objective was to compare health problems and medical coverage of homeless and housed children who used a school-based health center (SBHC) for comprehensive care.

Methods: Medical charts of homeless children (n = 76) and housed children (n = 232) seen for comprehensive care at an SBHC in New York City during the 1998-99 school year were systematically reviewed and compared.

Results: Controlled for ethnicity and medical coverage, homeless children were 2.5 times as likely (P <.001) to have health problems and 3 times as likely (P <.001) to have severe health problems as housed children. The most common health problems identified in the homeless population were asthma (33%), vision (13%), mental health (9%), and acute problems (8%). Lack of medical coverage was evident in 58% of homeless children, compared with 15% of housed children (P <.001).

Conclusion: Study findings identify homeless children as being at increased risk for health problems and lack of medical coverage. These findings support use of an SBHC for comprehensive care by underserved segments of the population and a need for increased vigilance on the part of health care providers caring for homeless children.