Chronic Health and Social Needs Increase School Absenteeism in Children: JAMA
USA: Researchers have found in a cross-sectional study that children with chronic health conditions and health-related social needs (HRSNs) are significantly more likely to experience prolonged school absenteeism. The probability of increased absenteeism was 4.4% among children with chronic health needs and 3.7% among those with HRSNs, compared to only 1.8% in children without these challenges. Notably, children facing both chronic health issues and HRSNs had the highest risk, with absenteeism rates rising to 9.4%, highlighting the compounded impact of medical and social factors on school attendance.
The study, published in JAMA Pediatrics, was led by Michelle Shankar from the Department of Pediatrics at the Children’s Hospital at Montefiore Einstein, Albert Einstein College of Medicine. It addresses a growing concern, as chronic absenteeism among school-aged children in the United States has surged in recent years, with more than one in four children missing significant school time during the 2022–2023 academic year.
For this purpose, the researchers analyzed data from the 2022–2023 National Survey of Children’s Health, focusing on children aged 6 to 17 years. The nationally representative sample included approximately 49.3 million children. Elevated health-related absenteeism was defined as missing 11 or more school days due to illness or injury within a year.
Key Findings:
- 6.8% of children, representing about 3.4 million, experienced high levels of health-related school absenteeism.
- More than half of the study population had chronic health conditions, health-related social needs (HRSNs), or both.
- These factors indicate a large group of children facing ongoing challenges that may disrupt regular school attendance.
- Chronic health needs included special healthcare requirements or long-term medical conditions.
- HRSNs included food insecurity, housing instability, parental health issues, and adverse childhood experiences.
- These social determinants affected school attendance both independently and in combination.
- Both medical and social vulnerabilities contributed to increased missed school days.
- The combined presence of chronic illness and HRSNs had the strongest impact on absenteeism.
- Children with both conditions were significantly more likely to miss extended periods of school compared to those without these challenges.
The authors suggest that these findings point to an important role for healthcare systems in addressing school absenteeism. By identifying children at higher risk and implementing targeted interventions, clinicians and policymakers may be able to improve both health and educational outcomes.
Overall, the study highlights the need for integrated approaches that consider both medical and social determinants of health. Addressing these interconnected factors could help reduce absenteeism and support better long-term outcomes for children.
Reference:
Shankar M, Levano SR, Lemberg M, et al. Health-Related School Absenteeism Among US School-Age Children With Chronic Health and Social Needs. JAMA Pediatr. Published online April 27, 2026. doi:10.1001/jamapediatrics.2026.1138
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