Leaders in public health and education gathered for a one-day summit to introduce a new framework: seeing chronic absence as a public health challenge. This approach expands the responsibility for reducing absenteeism beyond schools and centers it as a community-wide public health concern. (View the recording of the morning session!)
The June 10 summit, All in For Attendance, co-sponsored by Attendance Works, Kaiser Permanente and the Johns Hopkins University Center for School Health and the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health, brought together school health staff, pediatricians, local health clinics, policy makers and community organizations to discuss new ideas for collaborative action aimed at reducing chronic absence.
“Attending school regularly is one of the most powerful predictors of long term health, well-being and success,” said Josh Sharfstein, MD, Director, Bloomberg American Health Initiative, Johns Hopkins Bloomberg School of Public Health. Chronic absence is not just a problem about a child, a family or even a school. Chronic absence “is a signal like a vital sign that something in the child’s world isn’t working as it should and we need to listen to that respond to that and act together,” Sharfstein said.
Speakers in health and education discussed how individual and population group level data can guide collective action, and highlighted strategies to build strategic partnerships. Speakers also shared policies and programs that prevent absenteeism and promote regular school attendance.
Hedy Chang, executive director of Attendance Works noted that chronic absence rates are slowly heading down. Based on recent data, approximately 25% of students nationwide are chronically absent.
Key to improving high levels of chronic absence is to work collaboratively, within schools and districts, with community partners and health professionals, and across agencies, Chang said. “It is those collaborations that enable us to put the positive conditions for learning in place, and if we don’t, if we treat chronic absence with individual case management, those systems become quickly overwhelmed” and can end up failing. This then leads educators to resort to punitive action, which has not been proven to actually change what happens with attendance.
Four Short Term Actions
Chang shared four steps educators, health professionals and community members can take in the short term to improve student health, well-being and attendance:
1. Prioritize Prevention: Support relationships and healthy habits. Maximize access to school-linked and school-based health-related screenings and resources.
2. Engage in Messaging: Highlight why showing up to school regularly matters for well-being and learning, while providing consistent and up-to-date messaging on when a child should stay home.
3. Promote Teaming: Include school health team members (school nurse, social worker, counselor, etc.) on the attendance team.
4. Address Health Barriers: Identify, document and address health needs and barriers to attendance.
Best Practices for Messaging
Attendance Works presented an afternoon session, Here Today, Ready for Tomorrow! Messaging Health and Attendance. Elliott Attisha, Senior Fellow, Attendance Works identified health related barriers to attendance as well as their impact on student health, wellness and achievement, as well as Attendance Works health-related handouts for educators, families and community partners.
Sarah Clark, Co-Director, C.S Mott Children’s Hospital National Poll on Children’s Health, shared results of a new poll on parent’s perspectives on illness and school attendance. The results show that 52.8% of families said when it’s unclear whether their child is sick enough to miss school, they will keep a child home just to be safe. Just 3.9% of families call healthcare provider for advice about this decision.
Catherine Cooney, Communications Director, Attendance Works discussed draft rubric under development to help states and other groups develop quality messaging campaigns. A first step for any messaging is to understand the audience. Using surveys, interviews or focus groups, gather input from those you want to hear the messages to understand their perceptions, attitudes and any gaps in knowledge. Attendance Works has a variety of resources to help gather this input.
Kari Sullivan-Custer, Education Consultant, Attendance & Engagement Connecticut Department of Education shared the state’s health-centered attendance strategy and messaging campaign.
Kendra McDow, Medical Officer, the School District of Philadelphia, shared in a video the district’s Community-Wide Health Messaging Campaign.
Guiding Principles for a Public Health Framework
The co-sponsors released a white paper, “All in for Attendance: Collective Action for Public Health Strategies that Address Chronic Absence,” that frames chronic absence as a public health challenge and offers steps a community can take that address the root causes of school absence. The framework highlights real-world examples that illustrate how these principles can be put into practice including in Cincinnati, Baltimore, and Oregon.
The three action based guiding principles in the public health framework are:
1. Use school attendance data as a vital sign of student and community well-being
Student attendance data is often underutilized, inconsistent, or not tracked and shared effectively. The guide urges standardized data collection and wider use of attendance data to track absence patterns and connect them to broader measures of family and community well-being. The guide underscores the importance of secure and confidential data-sharing between schools, social services, healthcare providers, and other groups to enable earlier, more coordinated responses.
2. Develop strategic partnerships to align goals and drive progress on chronic absence
The guide offers specific actions to help communities strengthen relationships among educators, health practitioners, public health departments, and community-based agencies to align on goals, share data responsibly, combine resources and coordinate strategies that promote attendance and family engagement. These include outlining specific roles and responsibilities for each group, ways to align on shared messaging, and strategies to streamline funding or other resources.
3. Develop strengths-based policies and programs to promote school attendance and prevent chronic absence. Rather than leaving schools alone to address the root causes of chronic absence, the framework suggests that communities should invest in the conditions that can support the whole child, including health, housing, transportation and family engagement. It also suggests moving away from punishment-based policies and towards supportive, collaborative approaches to address school absence.
Resources
• Read the white paper, All in for Attendance: Collective action for public health strategies that address chronic absence.
• View the morning session of the Summit
• Read the opinion piece, by Josh Sharfstein and Bechara Choucair, Chronic Absenteeism Is a Vital Sign for Kids’ Health. New Framework Seeks a Cure
• Watch the recording of AAC Webinar #2 on May 14, 2025, Health, Well-being and Safety are Essential to Showing Up, featuring district and health leaders sharing how schools, health providers and other community partners can work as partners to promote health, well-being and safety at school.