school nurses. In this study, poverty stands out as
a variable consistently and strongly associated with
increased rates of all types of student visits to school
nurses. Poor children of all races and ethnic groups
had higher school nurse visit rates than nonpoor children,
and in many cases, considerably so.
The discrepancy between use of poor and nonpoor
populations according to race was widest with
White children, indicating that poverty was a larger
factor in driving their visits than those of children
of color. This indicates that race—or cultural or
economic factors associated with race—may be independent
variables in contributing to increased visits
to school nurses. Determining what these factors are
should be explored in future research.
This study also sheds new light on conventional
thinking about school nursing usage practices of racial
groups in the aggregate. Because usage rates among
Hispanic and Asian populations varied widely according
to subethnicity, use of aggregate data alone can be
misleading in presenting an accurate view of the status
quo. Assessing the strengths, needs, economic, and
cultural factors associated with subethnicity may be
more efficacious in informing and improving school
and public health nursing programs and policies