Director's Note

I talk a lot about getting to the root cause of chronic absence. The reality is, some absentee students are just plain sick. An estimated 22 million school days are lost annually to the common cold alone.

These absences, even if they're excused, can pile up and affect a student's academic performance. That's why medical and mental health providers are such important allies in our work. They're able to approach families in a nonjudgmental way and help them prevent illness and manage chronic health problems.

A nurse practitioner in North Carolina proved as much with a study that found her outreach to parents of chronically absent youngsters led to better attendance rates. In California, school-based health centers are especially effective. School officials in New York City are teaming with the Health Department this year for a new initiative to combat asthma.

Our website features a page offering more information and tips for health care providers.

- Hedy Chang

Nurse Practitioner's Outreach Improves Attendance

A pilot project using a nurse practitioner to contact the families of chronically absent students led to fewer absences, and it revealed an eye-opening attitude toward attendance in the early grades.

In a study set to appear in The Journal of School Nursing, nurse practitioner Jill Kerr monitored attendance at two North Carolina elementary schools and a Head Start program. Starting at the 30th day of the school year, she began tracking preK to 3rd grade students who had missed at least 10 percent of the days and contacting their parents. In some cases, at parents' request or if the absences exceeded 20 percent, she and a social worker visited homes.

The two elementary schools recorded 1,600 absences in the first 90 days, 70 percent of which were said to be for illness or injury. When Kerr spoke to parents, however, she found that 40 percent of the absences reported as illness were, in fact, unrelated to health. Respiratory illness was the leading cause of absences, but transportation problems and family activities followed close behind.

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Federal Health Care Reform Boosts In-School Health Centers

School-based health centers, which improve attendance as they address student health needs, now have a dedicated federal funding stream that provides for the construction and expansion of clinics across the country.

Under a little-known provision of the federal health care act approved last year, centers at public schools received $95 million in grants this summer. Research shows that school-based centers reduce the number of students sent home early for minor health problems and cut absenteeism rates for students with asthma. This 2009 Seattle study found that attendance rates increased for students who accessed medical services at their school-based health centers.

The California School Health Centers Association created the Resources For School Health web page and the Ready, Set, Success! toolkit to help schools launch school-based health centers and to show health providers how to maximize their efforts to reduce chronic absenteeism.

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Dental Policy Changes Could Fill Gaps in Care

Toothaches and dental problems contribute to millions of lost days of school each year, often because children have too little access to dental care. The Pew Children's Dental Campaign is working in states across the nation to encourage low-cost state policy reforms that could expand the dental workforce and address this critical health issue.

In California, where children missed 874,000 school days in a recent year because of dental problems, a coalition led by The Children's Partnership is urging policymakers to implement workforce solutions to ensure there are enough dental providers to meet the needs of California's children. The goal is to deploy providers, supervised by dentists, who could focus on preventive and basic restorative care. By extending the reach of dentists, new workforce models can help ensure all children get the high-quality dental care they need in a cost-effective way.

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Practice Spotlight

New York City Tackles Asthma, School by School

Recognizing the toll that asthma takes on school attendance, New York City is piloting an initiative in 18 elementary schools this fall to bring the chronic respiratory illness under control. Community partners, physical education teachers, parents, city agencies, even health clubs are working together to support children with asthma. Each school will have an "asthma ambassador" trained to provide support to individual support to students.

According to the City Health Commissioner, asthma is a leading cause of absenteeism. The mayor's Interagency Task Force on Truancy, Chronic Absenteeism, & School Engagement has launched the NYC Asthma Friendly Schools Campaign in conjunction with the Department of Education and the Department of Health and Mental Hygiene.

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Questions? For more information contact: or
Attendance Works Director Hedy Chang at

Attendance Works would like to express its deep appreciation to the
Annie E. Casey Foundation and the W.K. Kellogg Foundation for investing in our development and launch as a national initiative.
In addition, we thank The San Francisco Foundation and The California Endowment for supporting our campaign in California.


Issue 6, October 2011

Attendance Works is a national and state initiative that promotes awareness of the important role that school attendance plays in achieving academic success. It aims to ensure that every school in every state not only tracks chronic absence data for its individual students but also partners with families and community agencies to help those children.

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