POPULATIONS AT RISK ACROSS THE LIFESPAN: POPULATION STUDIES
Use of School Nurse Services Among
Poor Ethnic Minority Students in the
Urban Pacific Northwest
Robin Fleming
ABSTRACT Objectives: To determine whether patterns in student use of school nurse services existed
according to poverty, race, and ethnicity. Design and Sample: Cross-sectional descriptive study of 51,767
visits to school nurses made by 12,797 middle and high school students was conducted. Data were collected
and analyzed by race, ethnicity, and poverty. Measures: Individual-level quantitative data on student
visits to school nurses were collected via the School Nurse Entry Database. Numbers and types of student
visits were measured, along with the demographic characteristics of student visitors. Results: Poverty
was the largest driver of visits to school nurses among all racial and ethnic groups. Poverty was a larger
influence on White students’ use of services, suggesting that factors related to race, ethnicity, or culture
may have larger effects on promoting visits to school nurses by students of color. Subethnic Asian and
Hispanic groups showed visit patterns that deviated from aggregated visit rates. Conclusions: Knowledge
of visit patterns among poor, ethnic, and subethnic populations is important—and particularly urgent with
the advent of national health reform—in informing and improving public health and school nursing policy
and practice.
Key words: access to health care, race, school health.