JAMA study links needs to absenteeism

Michelle Shankar and co-authors reported on April 27 in *JAMA Pediatrics* that U.S. school-age children with chronic health conditions, health-related social needs, or both were more likely to miss substantial amounts of school for health reasons. The cross-sectional study used data from the 2022-2023 National Survey of Children’s Health and examined children ages 6 to 17. The authors found the highest estimated probability of elevated health-related absenteeism among children facing both medical and social complexity. An accompanying editorial in the journal said the findings point to the need for targeted support for school attendance. ### Which children were most likely to miss school for health reasons? The April 27 study found that children with both chronic health needs and health-related social needs had an estimated 9.4% probability of elevated health-related school absenteeism. That compared with 4.4% for children with chronic health needs alone, 3.7% for children with health-related social needs alone, and 1.8% for children with neither, according to the study’s key findings. (jamanetwork.com) Michelle Shankar, Samantha R. Levano, Miya Lemberg and colleagues defined the exposure group broadly. The paper said chronic health needs included children with special health care needs status or one of 27 chronic health conditions, while household-level health-related social needs included housing instability, food insecurity, parent health needs, or exposure to adverse childhood experiences. (jamanetwork.com) ### What data did the researchers use? The study used the 2022-2023 National Survey of Children’s Health and focused on U.S. children ages 6 to 17 with available school absenteeism data. The authors said their analysis was conducted from April to December 2025. JAMA Pediatrics described the paper as a cross-sectional study, meaning it measured associations in a nationally representative sample rather than testing whether one factor directly caused another. (jamanetwork.com) The paper’s objective was to examine associations between chronic health needs, health-related social needs and health-related school absenteeism among U.S. school-aged children. ### How does this fit into the broader absenteeism problem? The study said that in the 2022-2023 school year, more than 1 in 4 children in the United States were chronically absent from school, which it described as double prepandemic rates. The authors called the rise a public health concern because absenteeism can signal underlying health and social challenges. A June 24, 2024 *JAMA Pediatrics* viewpoint by Shankar, Danielle G. (jamanetwork.com) Dooley and Rushina Cholera also said that since schools reopened in 2021, more than 1 in 4 U.S. children had been chronically absent, defined there as missing at least 10% of school days for any reason. That article said the issue had prompted calls for an “all-hands-on-deck approach.” ### What did the editorial say schools and health systems should do? (jamanetwork.com) Genevieve G. Guyol, Kyle DeMeo Cook and Caitlin Lombardi wrote in the April 27 editorial that children with chronic health needs or health-related social needs had higher rates of health-related school absenteeism than children with neither. They said the findings highlight the need for targeted interventions to support school attendance among those children. (jamanetwork.com) A January 23, 2025 *JAMA Health Forum* article on school nurses offered one example of the kind of support often discussed in this area. Elizabeth Dickson, Robin Cogan and Rosa M. Gonzalez-Guarda wrote that school nurses play a central role in managing chronic conditions and coordinating care inside schools, and they cited historical evidence linking health interventions in schools to lower absenteeism. (jamanetwork.com) ### What can readers look at next? The study by Shankar and colleagues is published in *JAMA Pediatrics* with DOI 10.1001/jamapediatrics.2026.1138, and the related editorial by Guyol, Cook and Lombardi carries DOI 10.1001/jamapediatrics.2026.1274. The 2024 viewpoint on health systems and chronic absenteeism, also in *JAMA Pediatrics*, provides the journal’s earlier discussion of school-health coordination and attendance data. (jamanetwork.com 1) (jamanetwork.com 2)