Since the pandemic started, chronic absenteeism (missing 10% or more of school) appears to have doubled. Equally troubling, emerging data suggests that it remains persistently high, and it is contributing to immediate and long-term challenges to student well-being and academic success.
The key to improving attendance is addressing the causes that result in students missing school in the first place. While not the only cause of absenteeism, health-related barriers are major drivers. Both physical and mental health issues, which are affecting more families than ever, are likely to increase during the winter.
What can schools and districts do to overcome these challenges, create a healthy and safe learning environment and prevent avoidable health-related absences? They can partner with families and health providers to implement these three key strategies:
1. Provide clear guidance about when a child should stay home or show up to school for physical and mental health-related reasons.
Certainly, if a child has a contagious illness, it is important for them to stay home to get well and avoid getting other people sick.
It’s also important for families and school staff to be able to identify when students are feeling physically ill because of other reasons, like anxiety, depression or even the lack of proper nutrition. In these cases, showing up to school regularly to establish a regular routine or secure access to resources is an important part of the solution.
Local education agencies should work with health departments to develop and disseminate clear messaging and protocols to enable educators and health providers to help families and students judge whether staying home or showing up to class is the best course of action. This health guidance should:
- Include questions to help determine if a child has been exposed to Covid-19 or other contagious illnesses, is truly too sick to attend school and/or might be experiencing anxiety.
- Offer tips and resources that help students to keep learning and remain connected to their peers and teachers, if they must stay home.
- Provide messaging and resources using multiple methods (handouts, email, text, school website, social media, etc.) and translated into your community’s home languages.
Attendance Works winter messaging toolkit offers tips, messaging and resources to help families to keep students healthy.
2. Invest in tools and resources to prevent physical and mental health related absences.
Too often students miss class because of health-related absences (physical and mental health) that could be avoided. To help keep children healthy, consider these actions:
- Invest in welcoming and engaging school climates. (Watch Edutopia’s video for ideas on classroom activities. Or consult the Attendance Works Showing Up Matters for R.E.A.L. toolkit)
- Ensure students receive and have access to health screenings (behavioral, vision, hearing, dental, vaccines, Covid testing, etc.)
- Advocate for school-based health resources (nurses, health centers, social workers, etc.) and collaborate with local health providers to offer easy access to services (physical and mental health) so students don’t need to miss class to secure medical treatment. Telehealth options make this more possible than ever before.
- Ensure that early intervention and treatment services and supports (Tier 2 and 3) are in place to support student behavioral health needs.
- Put in place individual student health plans and permission to keep/use medications at school for those with chronic illness.
- Students with chronic health conditions have the additional anxiety about the potential that they may have a health-related emergency at school. Having a well-trained medical emergency response team in place to appropriately respond can help to reduce student worry.
- Educate students and families about how to stay healthy (adequate sleep, healthy eating, exercise, proper hygiene, annual physicals, vaccinations, etc.)
- Screen for and address food and housing insecurity.
- Create a healthy indoor environment through Indoor Air Quality management programs.
- Invest in monitoring systems that track health issues along with chronic absence, and the reasons (including health) that students miss school.
- Include school nurses and social workers on school attendance teams responsible for monitoring absences and implementing a prevention oriented, tiered approach to improving attendance.
Districts and schools can use Covid relief funds, and potentially use Medicaid funding to support school-based health services.
3. Invest in data sharing and collaboration between schools and health professionals.
Health professionals can be an invaluable and tremendous asset for helping to prevent and address health-related absences. The American Academy of Pediatrics (AAP) is urging schools to provide pediatricians with appropriate access to attendance data so they can better work with families to reduce health-related absences.
Improving data collection and data sharing partnerships between primary care providers and schools is one of 10 key priorities outlined by the Healthy Schools 10 Year Roadmap. Developed by National Healthy Schools Collaborative, a group of national organizations working in health and education, the roadmap’s priorities include providing healthy spaces to learn, play and work for every student and educator, and working as partners with families to improve student health and learning outcomes.
By Elliott Attisha, DO, Senior Fellow for Health with Attendance Works, and Hedy Chang, Executive Director, Attendance Works