School Absenteeism

Aka: School Absenteeism, Truancy, Student Absenteeism

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II. Definitions

  1. Chronic Absenteeism
    1. Missed school days (K-12) 10% of total (approximately 18 days in a U.S. school year)

III. Epidemiology

  1. Incidence of Chronic Absenteeism (U.S.): 6.8 Million (14% of students)
    1. Incidence varies by school (from 5 to 50%)
  2. More than 40% of missed school days claimed for illness or injury, were missed for other reasons
    1. Family reasons (e.g. parental illness)
    2. Social factors
    3. Lack of transportation

IV. Risk Factors

  1. School characteristics
    1. Urban schools with predominately non-white students or rural schools
    2. Unreliable or unsafe route to school
    3. Lack of peers at school
    4. Bullying (or other unsafe conditions)
    5. Poor school performance
    6. Frequent school absences at younger age (primary school, first few grades)
    7. No pre-kindergarden program
  2. Ethnicity
    1. American Indian
    2. Pacific Islander
    3. Black
    4. Hispanic
  3. Family Factors
    1. Homelessness or housing insecurity
    2. Food insecurity
    3. Incarcerated parent
    4. Parent did not complete school or did not attend college
    5. Parent had negative school experiences
    6. Lack of structure in home
    7. Parent unemployed
    8. Parent works multiple jobs or nightshift
    9. Child has caregiving responsibility at home
    10. Family members with chronic health conditions
  4. Health Conditions
    1. Chronic illness (e.g. Diabetes Mellitus, Asthma)
    2. Mental health conditions (e.g. ADHD, Major Depression, Anxiety Disorder)
    3. Substance Abuse
    4. Poor access to dental and medical care
    5. No school nurse
    6. Pregnancy (or parenthood)
    7. Insomnia
    8. Disabilities
  5. Social Factors
    1. Socioeconimically disadvantaged
    2. Member of socially ostracized group (e.g. lesbian, gay, Transgender)
    3. Non-english speaking
    4. Violence exposure

V. Complications

  1. Lower academic achievement
  2. School drop out
  3. Higher Risk behaviors
  4. Work absenteeism
  5. Lower income

VI. Prevention

  1. Identify children at high risk of absenteeism
  2. Intervene in children who have missed more than 5% of school days (approximately 9 missed days)
  3. Address school attendance as important in clinic visits
  4. Inquire about barriers (see risk factors above)
  5. Encourage pre-Kindergarden program (in pre-school aged children)
  6. Manage chronic medical and mental health conditions
    1. Establish sick-day plans (e.g. Diabetes Sick Day Management, Asthma Action Plan)
    2. Treat Anxiety Disorder, Major Depression and Attention Deficit Disorder
    3. Address Substance Abuse

VII. References

  1. Allen (2018) Am Fam Physician 98(12): 738-44 [PubMed]

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