Adolescents are at increased risk for many health-related conditions and also face considerable barriers to accessing health care. School-based health centers, which are primary health care sites located within a school or on school grounds, link vulnerable adolescent populations with developmentally appropriate and comprehensive care that is user-friendly, non-judgmental and confidential.

In 1996, Ravenswood Hospital Family Practice Residency Program, on recommendations derived from a comprehensive community health needs assessment, opened the first school-based health center on the northside of Chicago at Amundsen High School. Since its inception, this school-based health center has been instrumental in helping the disadvantaged youth of the Amundsen community overcome barriers to health care. Amundsen's success spurred Ravenswood Hospital to open a second health center in August 1998 at Lake View, another high school in its service area. Staff at both health centers include family physicians, clinical psychologists, health educators, nurse practitioners, office managers, and an administrative director. A Community Advisory Board and Student Advisory Board assist the staff at both health centers with policy and operational issues. All students attending the schools are eligible to be members of the Health Center. In order to receive services, however, students must have a signed parental consent form on file.

All health services are confidential and are provided regardless of students' ability to pay. Services include:

• diagnosis and treatment of illnesses
• mental health counseling
• substance abuse counseling
• school and sports physicals
• first aid for minor injuries
• reproductive health services
• health education
• immunizations
• basic lab services
• referrals for off-site services

In addition to being an effective environment for providing teen health services, school-based health centers provide far-reaching opportunities for training residents in adolescent medicine and community-oriented primary care. School-based health centers offer a broader range of ambulatory training options than the traditional family practice center or other hospital-affiliated outpatient settings. Training in this setting also offers residents the opportunity to be exposed to and comprehend the direct link between patient care and community involvement.

The success of the school-based health centers has been built on the commitment of and the partnership among the hospital, local social service and health care providers, the school administration, faculty and staff, the local school council, parents, students, community organizations, and business and religious leaders.

For more information on the school-based health centers at Amundsen and Lake View high schools, contact Elizabeth Feldman, M.D. For more information on school-based health centers, see the National Assembly of School-Based Health Centers or search for Making the Grade at George Washington University.