School-based health centers(SBHCs)are the health care facilities, literally what the name implies, locating on school campuses in the United States. SBHCs consist of various staffs of full- time or part-time employment such as nurse, nurse practitioner, physician assistant, physician, pharmacist, dentist, counselor, dietician, social worker, and psychologist depending on the needs of each school or school district. Most SBHCs open more than 30 hours per week, and their distinctive feature is that they can provide comprehensive health care services(e.g. primary care, mental health care, dental health care, health education, nutrition education, and behavioral health care)to children and adolescents on-site. The first centers opened in grass-root movements from the end of 1960s to the early 1970s; Cambridge, Massachusetts(1967), Dallas, Texas(1970), and St. Paul, Minnesota(1973). After 40 years passed, School-based health centers have grown from a handful to 1,909 in 45 states. Furthermore, as the Patient Protection and Affordable Care Act in 2010 specified the federal support of $200 million in funding for SBHCs from 2010 to 2013, SBHCs are now regarded as the mainstream of the school health system in the United States.
On the other hand, Japan hasn’t selected such SBHCs in the U.S. at all until now. As it is generally known, Yougo teachers, who are Japan’s original school health staffs, are placed in almost all schools by full-time employment, and assume administration of an emergency measure, management of the medical examination for the illness, health observation and consultation, and health education duties in Japan. However, in the present days the health and medical needs of the children and adolescents is becoming complex and diversified because of various problems such as mental health matters of children caused by bullying or truant, correspondences to children having abused or neglected experience and/or developmental disabilities, and security of medical opportunity for children in welfare household. Therefore, the role of school health and Yougo teachers will be necessary more and more in the future, and measures for enhancement and reinforcement of their function will be demanded.
Therefore, in this article, I(i)analyze the developmental processes and present situation of SBHCs in the U.S.,(ii)formulate "SBHC model" and put it into one strategy of enhancing school hygiene function as a supplement of Yougo-teacher-based system in our country which I stated above, and(iii)examine it’s suggestion to the our country.
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