· Chronic underfunding of public health (Trust for America’s Health [TFAH], 2019) leaving schools and school health services to fill the gaps in health promotion, prevention, and protection
· Includes underfunding for disaster responses including pandemics, natural and man-made disasters, mitigation, testing, contact tracing, and vaccination
· Inequitable funding of education system and infrastructure
· Crumbling infrastructure of the nation’s school buildings
· Persistent lack of holistic, child-centered systems of care.
· Inconsistent processes for analysis and dissemination of effective school health innovations
· Development of benchmarks for school health delivery systems that create stable, predictable, and equitable structures for school nursing work (e.g., lack of structures that may be available in other settings, Magnet Status in healthcare institutions)