During 1993-94, the Morrison Institute for Public Policy at Arizona State University conducted a study on behalf of the Arizona Department of Education. This document presents findings of that study, which examined linkages between health services and schools for a comprehensive service delivery to students. Following the introduction, chapter 1 provides a national overview on children's health and the public schools, presenting national and legislative initiatives and a framework for linking health services and schools. Chapter 2 reviews what is known about the major issues in child health in Arizona and its schools, synthesizing health data from several sources.

Survey results from 531 Arizona school principals about school-based/school-linked health and social services are also analyzed. A discussion of the Arizona perspective follows in chapter 3, which examines the philosophy guiding state initiatives, key players, the processes that support school-based/school-linked health services, and a sample of current state activities. The fourth chapter provides a view of how some Arizona schools are attempting to address these issues through the provision of student health services at or near school sites. The last chapter reviews action necessary to facilitate linkages between schools and health services, and the status of Arizona efforts. It concludes with some considerations for the future. A conclusion is that the state is making significant progress toward promoting and, in some schools, implementing such services. Eight tables and seven figures are included.

The biggest economic trend in Arizona over the last decade has been the flat line on various measures of prosperity relative to the national average. Arizona always has been below the national average on measures such as the average wage, earnings per employee, and per capita personal income. However, Arizona compares less favorably now than it did in the 1970s and early 1980s.

The war on poverty during the 1960s succeeded, cutting the national poverty rate in half by the early 1970s. Since then, however, the poverty rate of Americans under the age of 65 has increased. The poverty rate has climbed particularly among children; compared to an average of 15.5 percent during the 1971-to-1975 economic cycle, the poverty rate in each of the three cycles since 1982 averaged between 18 percent and 21 percent. One-in-five children lives in poverty and Arizona has consistently experienced higher poverty rates than the national average for all age groups except seniors.

Public finance—taxes and other revenues collected by government and the expenditure of those revenues—always has been somewhat controversial because of wide philosophical differences among residents regarding the role that government should play in providing public services and in collecting taxes and fees from its residents. Recently, public finance in Arizona has become a prominent public issue due to the need to resolve the deficits that afflict state government and most county and municipal governments in Arizona.