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Every Day Matters: Connecting Chronic Absenteeism and Student Health

Every Day Matters: Connecting Chronic Absenteeism and Student Health

Sick school girl with nurse checking temperature

I learned today from talking to LoraliGray,MEd, BSN, RN, NCSN and School Nurse Corps Administrator at the NWESD, that six million children nationwide are chronically absent from school. In Washington State, according to the Office of Superintendent of Public Instruction (OSPI), 16% of all students K-12 are chronically absent. This amounts to about 174,000 students! I was shocked. What does this mean? A student is chronically absent if they miss two days per month, or eighteen days total per year for any reason, excused or unexcused. The Healthy Schools Campaign notes that many of these absences are excused and are directly related to health reasons.

Historically, absenteeism improvement efforts have focused on truancy related to unexcused absences. This has sadly overlooked the impact of chronic absenteeism on students who miss school for health reasons. However, that is changing. I found that over the past two decades research has been conducted documenting the impact of health on academic achievement. Dr. Charles Bausch of Columbia University Teachers College is a well-known pioneer in this field promoting awareness of health disparities and their contribution to the achievement gap; the visible connection, chronic absences.

Although the causes of absenteeism are complex, the connection between health and absenteeism is clear and significant. Many common chronic and acute health conditions result in missed school days. Did you know that asthma is one of the top leading causes of school absenteeism both nationally and statewide and accounts for 1/3 of all missed days of instruction? The US Centers for Disease Control (CDC) has identified Washington asthma prevalence among the highest in the nation with nearly 120,000 children in our state living with asthma. Other chronic conditions such as diabetes, anxiety, obesity, oral health concerns and vision problems are also contributing factors. Nationwide, students ages 5-17 miss nearly 2 million school days annually due to dental problems. According to the 2014 Washington State Healthy Youth Survey, statewide, 46% of 12th-grade students who miss school due to a toothache are more likely to report lower grades (Cs, Ds or Fs). Acute illness such as influenza, strep throat, ear infections and seasonal allergies account for roughly 40% of school-aged children missing three or more days of school each year (Healthy Youth Campaign). When acute and chronic health conditions are combined with physical, social and environmental health disparities, the risk of absences increases, disproportionally affecting children of color, those with disabilities, and those living in poverty.

As I listen to conversations around our region and state about these concerns, some educators are asking what schools can do to address student health and chronic absenteeism? The literature is rich with suggestions; here are a few from the Healthy Schools Campaign Tool Kit:

  • Provide a healthy school environment that includes clean indoor air, well-maintained buildings, a safe and supportive climate, access to clean drinking water and adequate handwashing facilities.
  • Support access to school health and nursing services to ensure students with health conditions have appropriate care while at school.
  • Offer healthy breakfast and lunch programs.
  • Support access to behavioral and mental health services.
  • Provide sound policy for addressing absences and communicate to school staff, families and the community.
  • Provide physical education and activity throughout the school day.

Additionally, according to Dr. Charles Bausch, the most effective approach is collectively addressing these disproportional issues through the profound connection to chronic absenteeism. This means that students, families, schools and communities all share responsibility for this complicated problem by promoting awareness, building capacity and garnering resources. In an effort to do just that, in 2016, OSPI released data on district chronic absenteeism rates to assist individual districts in decreasing their numbers. While reviewing some of our region’s data, I noticed some interesting figures indicating chronic absenteeism rates as low as 5.7 % and as high as 22.59%. I encourage all districts to look at their data and take steps for improvement. Furthermore, OSPI, Department of Social and Health Services, and Mentoring Works WA have collaborated with Jermaine Kearse, a native Washingtonian and Seattle Seahawk, to record a wake-up Robo call for students and a notification of absence phone call for parents. All schools can arrange to utilize this brief, but impactful wake-up call.

(I have listened to it more than once!) To hear this message use these links from the OSPI website:

Parent Notification Call | Student Wake Up Call

I once heard someone say that being successful requires “showing up”. Every day matters so let's work together to help our students “show up” to school.

For more information contact:LoraliGray, MEd, BSN, RN, NCSNSchool Nurse Corps Administrator Johnson & Johnson School Health Fellow

Northwest Educational Service District (360) 299-4013 |lgray@nwesd.org| http://www.nwesd.org/nurse



  • Bausch, C.E. (2010). Healthier students are better learners: A missing link in school reforms to close the achievement gap. Equity Matters: Research Review, (6). New York: The Campaign for Educational Equity.

· Dilley, J. (2009). Research review: school-based health interventions and academic achievement. Washington State Board of Health, Washington State Office of Superintendent of Public Instruction, Washington State Department of Health.