Exploring Hospital Partnerships With K-12 Schools

Background: As chronic health and mental health conditions among US children worsened over the past 17 years, partnerships between hospitals and schools have emerged as a promising strategy to improve child health and expand access to care. However, limited research has examined hospital-school partnerships, particularly the hospital-level factors associated with engagement with K-12 schools. This study explored the associations between hospital characteristics and the presence and level of engagement in hospital-school partnerships. Methods: Using data from the 2023 AHA Annual Hospital Survey, we conducted a mixed-effect logit model to explore the association between hospital characteristics and the presence of hospital-school partnerships, and a partial proportional odds model to examine factors associated with the extent of engagement in these partnerships. Both models adjusted for the number of nonschool partnerships and market competition. Results: For-profit hospitals ( OR =0.49; P <0.001) and independent hospital systems ( OR =0.49; P <0.001) had significantly lower odds of engaging in hospital-school partnerships. Hospitals providing pediatric care ( OR =1.70; P <0.001) and critical access hospitals ( OR =2.70; P <0.001) were more likely to engage in at least 1 partnership activity with K-12 schools. The number of nonschool partnerships was significantly associated with the presence ( OR =1.51; P <0.001) and a greater extent of engagement ( OR =1.40; P <0.001) in hospital-school partnerships. Conclusions: Our findings showed that critical access hospitals, sole provider status hospitals, and hospitals that provided pediatric care were more likely to engage in hospital-school partnerships, whereas for-profit hospitals and hospitals in independent systems were less likely to do so. Hospitals with more nonschool partnerships had a greater extent of school partnerships, suggesting that broader organizational capacity for cross-sector collaboration may facilitate stronger hospital-school partnerships. Policymakers may leverage these insights to develop incentives that support hospital-school partnerships and equitable access to care for children.