Health Issues and Absenteeism

These reports are listed alphabetically.  For more information about this issue, please visit Tools for Healthcare Providers. Also see this research summary created by the National Collaborative for Education and Health.

  • Basch, Charles. Healthier Students Are Better Learners: A Missing Link in Efforts to Close the Achievement Gap, Equity in Education Forum Series, March 2010; Teachers College, Columbia University.This report concludes that “six educationally relevant disparities”—vision problems, asthma, teen pregnancy, aggression and violence, physical inactivity, poor nutrition, and concentration problems—have negative academic outcomes for minority students in urban settings. The piece hits also on data about the relationship between health and school attendance: “Compared with children without the condition, some studies have also found, children with asthma tend to have more problems with concentration and memory, to have their sleep disrupted, and to miss more days of school. One 2003 estimate, in fact, blamed the disorder for 12.8 million school absences across the country that year.”
  • Geier, Andrew B. et al. The relationship between relative weight and school attendance. Obesity, Vol. 15 No. 8. August, 2007. This study examined the association between relative weight and absenteeism in 1,069 fourth to sixth graders from nine public schools in an urban area. The researchers found that obese children were absent significantly more than the normal weight children.  Several possible reasons for lower attendance are social difficulties and behavior problems, as well as medical conditions, such as asthma, associated with obesity.
  • Henderson, Tia et al., The Connection Between Missing School and Health: A Review of Chronic Absenteeism and Student Health in Oregon, Upstream Public Health, October 2014. Upstream Public Health looks “upstream” at factors in communities, at home, and at schools that lead to chronic absenteeism. The report reviews data and research on student absences — finding that unexpected factors such as unstable housing, fear of bullying, and punitive school discipline policies as well as health conditions such as hunger, dental pain, respiratory illness, and depression contribute to absenteeism. Additionally, it explores how adults with less education are more likely to smoke, be overweight, have diabetes, and die prematurely of certain chronic conditions.
  • Hillman, Charles H. et al., Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function. Pediatrics, September 29, 2014. This study found significant differences between students in the afterschool program and those on the wait list. Students in the intervention group improved two-fold when tested on accuracy and cognitive tasks compared to the students who did not participate in the afterschool program. Researchers found widespread changes in brain function, meaning greater amounts of executive control in the students that engaged in physical activity while participating in the afterschool program. Students in the program also improved both their overall fitness and their school attendance rates.
  • Kerr, Jill et al., Does Contact by a Family Nurse Practitioner Decrease Early School Absence?, The Journal of School Nursing, September 14, 2011. Chronic early school absence is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers can facilitate a healthier population resulting in improved attendance. This article describes a nursing intervention to decrease early school absence in two elementary schools and a Head Start program.
  • Leading Health Conditions Impacting Student Attendance, National Collaborative on Education and Health, September 2015. This handout summarizes the research linking health and attendance.
  • Levy, Douglas E., Jonathan P. Winickoff, Nancy A. Rigotti, School Absenteeism Among Children Living With Smokers, Pediatrics: Official Journal of the American Academy of Pediatrics, September 2, 2011. Children of parents who smoke have worse attendance than their peers with healthier parents, according to this study. Researchers looked at data from the 2005 National Health Interview Survey to assess the relationship between adult-reported household tobacco use and child health and school attendance. Children who experienced tobacco exposure had significant academic disadvantages.
  • Mapping the Early Attendance Gap: Charting a Course for Student Success. Attendance Works and Healthy Schools Campaign, September 2015. This report shows how disparities in school attendance rates starting as early as preschool and kindergarten are contributing to achievement gaps and high school dropout rates across the country. The report also highlights the connection between health and attendance and the power of states to tackle absenteeism by tapping key champions, leveraging data, and learning from places that have improved attendance despite challenging conditions.
  • McKeever, Pamela M., Clark, L., Delayed High School Start Times later than 8:30 a.m. and Impact on Graduation Rates and Attendance Rates, Sleep Health, In Press, March 2017. The authors analyzed the association between a delayed high school start time later than 8:30 a.m. and attendance and graduation rates. Approximately 29 public high schools from eight school districts located throughout seven different states were identified using previous research from the Children’s National Medical Center’s (CNMC) Division of Sleep Medicine Research Team. The study provides statistical evidence that both attendance rates and graduation rates are significantly improved after the implementation of a delayed morning bell. The investigation also raises questions about whether later school start times are a mechanism for closing the achievement gap due to improved graduation rates.
  • Mendell, Mark et al. Association of Classroom Ventilation with Reduced Illness Absence: A Prospective Study in California Elementary Schools, Indoor Air, vol 23, issue 3, April 2013. This report found that bringing classroom ventilation rates up to the state-mandated standard may reduce student absences due to illness by approximately 3.4 percent.  Extensive data on ventilation rates was collected from more than 150 classrooms in California over two years.  The study found that ventilation rates varied widely across the districts, within districts, and even within schools, and that portable classrooms, on average, had less ventilation.
  • Nandrup-Bus, Ange. Comparative studies of hand disinfection and hand washing procedures as tested by pupils in intervention programs, American Journal of Infection Control, Vol. 39, Issue 6, August 2011.The objective of this study was to determine the effect of mandatory, scheduled hand disinfection (HD) on actual absenteeism because of infectious illness in elementary school pupils in Denmark.  A three-month experiment compared one school in which students were required to wash their hands three times a day, with another where hand washing was not required. Hand-washing was shown to significantly decrease absenteeism.
  • Pourat, Nadereh and Gina Nicholson, Unaffordable Dental Care Is Linked to Frequent School Absences. UCLA Center for Health Policy Research, November 2009. Tooth decay is the single most common chronic disease of childhood and affects nearly 60% of children in the United States.  In 2007, approximately 7% of school-age children in California missed at least one day of school due to a dental problem.  The ability to afford needed care is the key difference between those children who miss school and those who do not.  This report examines the link between unaffordable dental care and missed school days, especially among children who are uninsured, lower-income, limited English-proficient, Asian American, and who have poor oral health.
  • Promoting Improved Oral Health: Legislator Policy Brief,  Healthy States Initiative, Council of State Governments, June 2008. This policy brief addresses the impact of oral diseases among children and adults. Among school-age children (5 to 17), tooth decay is the most common chronic disease — five times more prevalent than asthma and seven times more prevalent than hay fever.  Children lose approximately 50 million school hours each year to dental-related illnesses, and low-income children lose 12 times as much.  This report also provides state policy examples from Arkansas, Colorado, Tennessee, and Ohio.
  • State of Chronic Absenteeism and School Health: A Preliminary Review for the Baltimore Community. The Baltimore Student Attendance Campaign and Elev8 Baltimore, April 2012.  To address the problem of health-related absenteeism, Elev8 Baltimore and the Baltimore Student Attendance Campaign collaborated to prepare a preliminary review of absenteeism and school-based health services (referred to in this report as school health) in Baltimore City. This review aims to analyze existing data, policies, and programs to create a snapshot of what is currently being done to address health-related absenteeism in the city. While not an exhaustive analysis of school health, it is a first look into the links between absenteeism and school health from a local, state and national perspective.
  • Van Cura, Maureen. The Relationship Between School-Based Health Centers, Rates of Early Dismissal From School, and Loss of Seat Time, Journal of School Health, Vol. 80, No.8, August 2010.This researcher studied two high schools in New York  – one with a school-based health center and one without. Controlling for race, gender, age, poverty,  and presence of a  pre-existing illness, this study shows that school-based health centers have a direct impact on educational outcomes such as attendance.
  • Webber, Mayris P., et al, Burden of Asthma in Inner-City Schoolchildren: Do School-Based Health Centers Make a Difference? Arch Pediatrics Adolescent Medicine Volume 157, February 2003.This study compared information about students at six inner-city elementary schools in the Bronx. Four of the schools had school-based health centers while two did not. Researchers looked at data regarding hospitalization, emergency department visit, and absenteeism among students with asthma. They found that access to school-based health centers reduced the rate of hospitalization and decreased absenteeism for students with asthma.
  • Weismuller, Penny C., Merry A. Grasska, Marilyn Alexander, Catherine G. White, and Pat Kramer. Elementary School Nurse Interventions: Attendance and Health Outcomes, The Journal of School Nursing, April 2007; vol. 23, 2: pp. 111-118. Regular school attendance is a necessary part of the learning process; student absenteeism has a direct association with poor academic performance. School nurses can influence student attendance. This study describes the impact of school nurse interventions on student absenteeism and student health. A retrospective review of 240 randomly selected elementary student health folders and attendance records was conducted. School nurses were involved with 75% of high-absence students as compared to 66% of low-absence students; they were also more involved with students who had previously identified health conditions.
  • Wheaton, Ann, Most US middle and high schools start the school day too early. Students need adequate sleep for their health, safety, and academic success, Centers for Disease Control and Prevention, August 6, 2015. Fewer than 1 in 5 middle and high schools in the U.S. began the school day at the recommended 8:30 AM start time or later during the 2011-2012 school year, according to data published today in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Too-early start times can keep students from getting the sleep they need for health, safety, and academic success.
  • Woods, Elizabeth R. et al., Community Asthma Initiative: Evaluation of a Quality Improvement Program for Comprehensive Asthma Care. Pediatrics, February 20, 2012. Asthma is one of the most common chronic illnesses for children in the United States, and rates have reached historically high levels nationally with large racial/ethnic health disparities. Preventive efforts to address asthma issues in early childhood have been found to return $1.46 for every dollar invested, by reducing hospital visits. Additionally, there was also a 41% reduction in missed school days, and a 50% reduction in parents missing work due to an ill child.