Students who are uninsured, racial or ethnic minorities, and/or low-income often face barriers to healthcare, and may be vulnerable to poor health and academic outcomes. School-based health centers (SBHCs) address youth barriers to healthcare and promote health equity by providing primary medical and mental health services, as well as health education programming. SBHCs have important ramifications for students' health, behaviors, and lives. Historically, SBHC research has largely focused on service utilization; little work examines the longitudinal impact and potential causal mechanisms of SBHCs on student outcomes. Academic outcomes are of particular interest to SBHC practitioners, schools, and families, given the implications for funding and benefits for students. In the present study, a conceptual framework developed by Geierstanger, Amaral, Mansour, and Walters (2004) guided the prediction that SBHC use would indirectly improve student academic performance through increases in general health status and levels of physical activity. These relationships were examined using longitudinal structural equation modeling with data from the Michigan Evaluation of School-based Health (MESH) Study (McNall, Lichty, Mavis, & Bates, 2010). Results indicated that student SBHC use was not associated with self-reported health status, physical activity, or academic performance. While this study addressed gaps in SBHC literature, such as the lack of longitudinal methods, additional research is needed to better understand these relationships. Implications for future SBHC research, policy, and practice are discussed.
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