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For many Philadelphians like Mitata Gbondo with young children, going to the dentist can be inconvenient, expensive and even scary.
So when a dental clinic opened at her son's William D. Kelley Elementary School, Ms. Gbond jumped at the chance to get free teeth cleanings for herself and her son. She went up to her third floor of the school at noon Thursday and entered a fully functioning dental clinic with candy-colored walls and pictures of smiling toothpaste mascots.
“This experience has been amazing,” Gbond said.
School-based clinics like William D. Kelley Dental Clinic are rapidly expanding across the United States. Experts say students who receive free, comprehensive health checkups, testing and even behavioral therapy, especially those living in low-income areas, do better academically and mentally.
Data from Education Plus Health, a nonprofit advocacy group lobbying for more health centers in schools in Philadelphia, shows that from 2022 to 2023, 3 in 5 students attended schools with centers. Attendance rate improved from the previous school year.
However, these clinics are often underfunded and understaffed, and typically cannot operate without the financial support of hospitals, community health partners, and universities.
Approximately 23 states have passed legislation to stabilize funding for school health centers by allocating state funds to them each year. But Pennsylvania is not among them.
“We just don't have a robust system of school-based health centers,” said Kendra McDough, medical officer for the Philadelphia School District.
The district is trying to change that. McDow said he is looking for a medical partner to help establish new school-based health centers in one or two district schools over the next three years. After that, McDow said he hopes to increase that number.
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Julie Kassler, executive director of the Pennsylvania School Health Alliance and Education Plus Health advocacy group, said there are more than a dozen school-based health centers in Philadelphia and 30 total in the state. That's what it means. Most are enrolled in private or charter schools. Like school health centers across the country, Philadelphia school health centers are funded by federal aid, insurance reimbursements, philanthropic contributions, and some one-time state grants. Masu.
Only three schools in the Philadelphia area (Building 21, John B. Stetson Middle School, and Vaux Big Picture High School) have comprehensive school-based health centers staffed by nurses. The planned clinic at Edward Gideon Elementary School has not yet opened, but Kelley does have a dental clinic.
Meanwhile, New York state has 252 centers in schools (146 of them in New York City), and Delaware, the first state to require centers in all public high schools, has more than 50, according to the state health department. There is a center. New Jersey just opened its first school-based health center in 2023, but recent funding cuts in New York and Delaware have put these centers in jeopardy.
Kazler and McDow said the center will specifically target students in Philadelphia because living in a city near multiple freeways, industrial facilities and other sources of pollution can cause or worsen chronic health problems such as asthma. said that it is essential for These chronic health problems can cause students to frequently miss school or have difficulty concentrating in class, McDow said.
According to data from the Centers for Disease Control and Prevention, 21% of Philadelphia children have asthma, which is more than double the national prevalence rate.
“We have higher rates of asthma, higher rates of uncontrolled asthma, and higher rates of hospital admissions for asthma,” Kazler said. “We have high rates of mental health problems among children, and high rates of children who are not getting the services they need. So we have to start going where the children are.”
McDow said if Philadelphia officials want to make school-based health centers “really work for the city, they need funding.” And she said that means state-level laws.
Under Gov. Josh Shapiro's latest budget proposal, school-based health centers will not receive dedicated funding from the state.
“Currently, there is no support for school-based health centers, which is why it is difficult to sustain them,” Kazler said.
“A hub for everything families need”
In the early 1990s, under former Gov. Robert P. Casey, Pennsylvania hired Robert Wood Johnson to launch a network of school-based health centers in high-need areas, according to its first governor, Cliff Dierdorf. He said he received a series of grants from the foundation. Public Health Program Administrator for Pennsylvania Department of Health Grants. From 1987 to his 2001, the foundation spent $40 million on school-based health centers across the country.
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Dierdorf said there is great momentum behind this new initiative.
“I was excited. This was a new idea for Penn State,” Dierdorf said. “We were starting something hoping to make a difference.”
But when the grants ran out, nearly all of those centers closed. According to Deardorff, only one original school-based health center currently exists.
Deardorff said it's important for any type of medical center to build community trust to keep patients coming back, staff employed and reimbursements flowing.
“It was painful to give someone a chance to start something like this and then, oh, it's gone,” Dierdorf said.
But he said he's hopeful that, encouraged by advocates like Kazler, state lawmakers may be able to avoid past fiscal mistakes.
Crystal Edwards, principal at William D. Kelley Elementary School, said it's an “honour” to have a dental office in her building. She said she has seen the program's positive impact on her students, their families, and even staff who can access the clinic's services regardless of their insurance status.
“We are at the heart of what families need to make sure their children are not only physically safe and educationally safe, but also psychologically and emotionally safe. We strive to be that, and we're proud to be able to offer that to our community,'” Edwards said.
Carly Citrin is Chalkbeat's Philadelphia bureau chief. Contact Carly: csitrin@chalkbeat.org.
