Chronic Absenteeism Directly Affects Lifetime Learning
Chronic absenteeism—or missing 10 percent or more of school days for any reason, excused or unexcused—detracts from learning and is a proven early warning sign of academic risk and school dropout. Nationwide, a staggering number of children are chronically absent, often at a very young age and often without attracting attention or intervention.
While the causes are multi-fold, one stands out as especially significant: student health.
Students with unmanaged chronic health conditions (such as asthma or diabetes) are more likely to miss class because of the symptoms of their illness or because they are receiving medical treatment during the school day. Students can also be chronically absent because of health issues such as fever, flu, dental pain, vision problems or mental health and anxiety issues.
Compounding the problem is the fact that many students do not have access to healthy school environments.
The crisis of health-related chronic absenteeism is especially poignant as it primarily affects young children in ways that can shape academic outcomes for their entire school career. For example, research shows that children who are chronically absent in both kindergarten and first grade (such as a child who suffers frequent asthma attacks) are much less likely to be reading at grade level by the third grade; and students who are not reading at grade level by the third grade, in turn, are four times more likely to drop out of high school.
Policy change to support student health is a critical step to addressing chronic absenteeism and a key opportunity to make a profound positive impact on children’s lifelong learning and health. It also offers a natural opportunity for collaboration among the health, public health and education sectors.
The Challenge We’re Facing
Our nation now has the highest graduation rates in its history and education leaders—from policymakers at the state and federal level to educators on the ground in schools—are working hard to ensure all students receive a quality education. Yet even the most thoughtful efforts to reduce dropout rates and address the achievement gap are threatened by the problem of chronic absenteeism. Chronic absenteeism isn’t just a matter of truancy or skipping school. In fact, many of these absences are excused and tied directly to health factors.
A snapshot of the current environment shows:
- 5 million to 7.5 million students across the U.S. miss nearly a month of school each year.
- Children who are chronically absent in both kindergarten and first grade are much less likely to be reading at grade level by the third grade; and students who are not reading at grade level by the third grade, in turn, are four times more likely to drop out of high school.
- Rates of chronic illness are highest among students from low-income families, communities of color and those with disabilities.
- Asthma is a leading cause of school absenteeism, accounting for one-third of all days of missed instruction. Children with persistent asthma are more than three times as likely to have 10 or more absences than their peers.
- Children between 5 and 17 years miss nearly two million school days per year nationwide due to dental problems. A full twenty percent of children aged 5 to 11 years have at least one untreated decayed tooth.
Chronic Health Conditions
Students with unmanaged chronic health conditions (such as asthma or diabetes) are more likely to miss class because of the symptoms of their illness or because they are receiving medical treatment during the school day.
The examples of asthma and oral health illustrate the scale of this challenge:
- Asthma. Nearly one in 10 children (9.9 percent) age 4-14 are diagnosed with asthma. Asthma is a leading cause of school absenteeism, accounting for one-third of all days of missed instruction. Children with persistent asthma are more than three times as likely to have 10 or more absences than their peers. Asthma can be exacerbated by factors in the school environment, particularly issues such as mold or harsh cleaning chemicals that have an impact on indoor air quality. Yet it doesn’t have to be this way: Research has shown that creating healthy indoor environments and providing adequate levels of school nursing can all but eliminate the disparity in attendance between students with asthma and their peers.
- Oral health. A full 20 percent of children age 5-11 have at least one untreated decayed tooth. Among school-age children, tooth decay is the most common chronic disease, five times more prevalent than asthma. Children age 5-17 miss nearly two million school days in a single year nationwide due to dental health-related problems. Children with poor oral health status are nearly three times more likely than their counterparts to miss school as a result of dental pain. Tooth decay and dental pain are easily treatable if students have access to dental care; the consequences of leaving such pain untreated are significant not only for children’s lifetime health but also for their education. Schools can take on this issue by partnering with public health and health providers to increase access to dental services.
Of course, the problem of health-related chronic absence goes far beyond these two issues. Research indicates that other common health conditions resulting in missed school include diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), influenza, diabetes, obesity, seizure disorders, mental health and anxiety, and vision problems. Other health-related factors such as food insecurity, housing insecurity and violence in the community also play a significant role.
Access to Healthy School Environments
Compounding the problem is the fact that many students do not have access to healthy school environments.
For example, less than 50 percent of the nation’s students have access to a full-time school nurse or school counselor, and less than 5 percent of the nation’s students have access to health services through a school-based health center. In addition, one in five schools in the United States reports unsatisfactory indoor air quality, a known trigger of asthma attacks. Low-income children are less likely to have access to a healthy school environment. Students in low-income schools are less likely to have recess and high-quality physical education than students in higher income schools. In addition, students in low-income schools are more likely to have no school nurse or have higher ratios of students to nurses than higher-income schools.
Despite the scale of this problem, we must remember that health-related chronic absenteeism is not an inevitable fact of childhood. Keep reading for more on what we’re doing and what you can do.
Reducing Absenteeism by Supporting Healthy Schools
HSC’s innovative programs are designed to address health-related chronic absenteeism by ensuring that children are able to attend school in healthy school environments. A healthy school environment includes regular access to school health services (including physical, mental, dental, vision and behavioral services), healthy school food, physical activity, good indoor air in a clean and well-maintained building, access to water and a supportive school climate and culture.
HSC works at the national, state and local levels to ensure that both the health and education sectors have the tools and information necessary to understand and address the health-related causes of chronic absenteeism.
HSC and Attendance Works are currently collaborating on Here + Healthy, an initiative to raise awareness about the health-related causes of chronic absenteeism, and the proven solutions. Find out more at hereandhealthy.org.
What You Can Do
Taking action to address health-related chronic absenteeism can have a powerful impact on students’ academic success and well-being for a lifetime. There is much we can do as a society to address this issue and relieve the lifelong burden it places on young children. Cross-sector collaboration—particularly connecting the education community with the public health community and the medical community—can play a powerful role in mustering the resources to make lasting change.
HSC and Attendance Works are currently collaborating on Here + Healthy, an initiative to raise awareness about the health-related causes of chronic absenteeism, and the proven solutions. Find out more at hereandhealthy.org.
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