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South Carolina is a very rural state with significant health care deserts; for example, some counties have no pediatricians. This creates barriers to care and results in poor health care outcomes and significant health disparities.

In 2016, with support from Healthy Schools Campaign and Trust for America’s Health, the U.S. Departments of Education and Health and Human Services launched HSPF out of the growing recognition of the connection between health and learning. The Ohio team's progress in building capacity, strengthening cross-agency relationships, and launching its statewide initiative to align health outcomes with academic success through the development of a School-Based Health Care Support Toolkit.