II. Definitions
- Chronic Absenteeism
- Missed school days (K-12) 10% of total (approximately 18 days in a U.S. school year)
III. Epidemiology
IV. Risk Factors
- School characteristics
- Urban schools with predominately non-white students or rural schools
- Unreliable or unsafe route to school
- Lack of peers at school
- Bullying (or other unsafe conditions)
- Poor school performance
- Frequent school absences at younger age (primary school, first few grades)
- No pre-kindergarden program
- Ethnicity
- American Indian
- Pacific Islander
- Black
- Hispanic
- Family Factors
- Homelessness or housing insecurity
- Food insecurity
- Incarcerated parent
- Parent did not complete school or did not attend college
- Parent had negative school experiences
- Lack of structure in home
- Parent unemployed
- Parent works multiple jobs or nightshift
- Child has caregiving responsibility at home
- Family members with chronic health conditions
- Health Conditions
- Chronic illness (e.g. Diabetes Mellitus, Asthma)
- Mental health conditions (e.g. ADHD, Major Depression, Anxiety Disorder)
- Substance Abuse
- Poor access to dental and medical care
- No school nurse
- Pregnancy (or parenthood)
- Insomnia
- Disabilities
- Social Factors
- Socioeconimically disadvantaged
- Member of socially ostracized group (e.g. lesbian, gay, Transgender)
- Non-english speaking
- Violence exposure
V. Complications
- Lower academic achievement
- School drop out
- Higher Risk behaviors
- Work absenteeism
- Lower income
VI. Prevention
- Identify children at high risk of absenteeism
- Intervene in children who have missed more than 5% of school days (approximately 9 missed days)
- Address school attendance as important in clinic visits
- Inquire about barriers (see risk factors above)
- Encourage pre-Kindergarden program (in pre-school aged children)
- Manage chronic medical and mental health conditions
- Establish sick-day plans (e.g. Diabetes Sick Day Management, Asthma Action Plan)
- Treat Anxiety Disorder, Major Depression and Attention Deficit Disorder
- Address Substance Abuse