School-Based Health Services and Adolescents' Academic Performance The Role of School Provision of Preventive and Physical Health Services in Educational Outcomes

Research indicates a reciprocal relationship between health and education, and that unhealthy students are poorly positioned to learn. One way that schools intervene in the relationship between student background and educational outcomes is by providing services that prevent health problems or help students cope with existing health concerns. Providing health services on campus is theorized to promote educational goals by increasing access to services, improving health, and thus enhancing opportunities to learn. However, empirical tests of this relationship are rare, and generally use small samples with a single service or full-scale clinic. This paper uses data from Add Health, which identifies numerous services provided by schools across the U.S. Multilevel models test how provision of preventive or physical health services relates to adolescents’ academic performance as well as implications for racial and socioeconomic educational inequality. Analyses consistently demonstrate that school provision of preventive/physical health services is positively related to youths’ educational outcomes, including a higher GPA, lower odds of failing courses, and higher odds of graduating from high school, but also little evidence of differing associations across student subgroups. Additional results mitigate concerns that these relationships are biased by selection and offer evidence that increased opportunities to learn are one mechanism for the positive role of health services.