Use of School Nurse Services Among Poor Ethnic Minority Students in the Urban Pacific Northwest


Robin Fleming, 3013 S. Mt. Baker Blvd., Seattle, WA 98144. E-mail:


ABSTRACT Objective: 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.