It makes sense, given the role that student health plays in absenteeism. A study in central Texas by the Austin-based E3 Alliance, for instance, found that 52 percent of absences were due to chronic or acute illness. By contrast, skipping school accounted for 5 percent. Similarly, a study of Chicago preschoolers by the University of Chicago Consortium on Chicago School Research found 54 percent of the absences were due to illness, while transportation, child care and family-related factors together accounted for only 18 percent of missed days.
Research makes clear the academic cost of lost instructional time: weaker social skills in kindergarten, poorer reading scores in third grade and lower graduation rates in high school. The AAP guidance goes a step further, linking these weak academic outcomes to poorer health and economic conditions later in life. And it cites research connecting absenteeism with risky health behavior, such as cigarette use, substance abuse and teen pregnancy.
So what can pediatricians do about absenteeism?
AAP’s recommendations start with using office visits as an opportunity to talk about school attendance. That could mean asking children and their parents about how many days they’ve missed and why. Or talking about the importance of good attendance for academic attainment. Or exploring whether suspensions or disciplinary actions reflect mental health concerns that need more attention. The guidance includes handouts and a waiting room video focused on school attendance.
Beyond the doctor’s office, AAP urges its members to join broader community efforts to improve school attendance and academic outcomes. Pediatricians can work with school and public officials to identify health causes of absences and brainstorm responses. They can help enroll eligible children in Medicaid and CHIP and help all families find a medical home.
They can educate school staff about how to manage chronic illnesses. And they can argue against policies that keep kids home unnecessarily.
The AAP policy statement comes at a time when 36 states and the District of Columbia are holding schools accountable for their chronic absenteeism rates, generally defined as the share of students missing 10 percent or more of the school year for any reason, excused or unexcused. It also mirrors a growing awareness of the impact of physical and mental health on a child’s social, emotional and academic development. Educators will need all the help they can get in this work. Pediatricians are a logical partner.
