School Nursing Workforce Differences Between Urban and Non-Urban Areas: Implications for School Health Services and Equity.

The professional experiences of school nurses who work outside of urban areas are not often described. We used data from a 2019 statewide survey of school nurses to describe differences between the urban and non-urban (urban cluster and rural) school nurse workforce in New Mexico. Non-urban school nurses were twice as likely as urban nurses to provide clinical services to multiple school campuses ( P   <  .001) and more likely to serve both elementary and secondary school settings ( P   =  .002). They were less likely than urban school nurses to be bachelor's prepared, or to have received recent continuing education on diabetes ( P   <  .001), reproductive health ( P  = 0.02), LGBQ+ and transgender student health ( P   <  .001, for each), and suicide risk assessment and screening ( P   =  .012). Our findings underscore concerns about geographic differences in the school nursing workforce in terms of educational preparation and student access that could potentially limit the school nurse role in advancing child health equity.