How Does Access to Health Care Affect Health and Education? Evidence from School-based Health Center Openings

The large amount of money spent on expanding access to health care in the US to low-income Amer-icans combined with persistent disparities in health and education across the socioeconomic distribution leads to the important question of how expanding health care access could help address these disparities. This paper examines the provision of primary care health services to low-income students that are deliv-ered through school-based health centers (SBHCs). Using the timing of center entry and exit combined with changes in service levels from year to year at these centers, we estimate how the primary care services provided by SBHCs affect teen pregnancy and high school dropout rates. Our preliminary results indicate that school-based health centers have a large, negative effect on teen birth rates: adding services equivalent to the average SBHC reduces the birth rate for girls 15 and under by 23 % and reduces the 16-19 year old birth rate by 8%. These effects are driven solely by centers that offer contraceptive services. Despite the large effect on teen childbearing, we find at most a small effect on high school dropout rates. However, any dropout rate effect is localized to females. These results suggest that primary care health services do not reduce high school dropout rates by much, even when they reduce teen birth rates. This does not mean, how-ever, that SBHCs do not make students better off, as reducing teen fertility may be desirable in its own right