On June 10, 2025, Kaiser Permanente co-convened the All in for Attendance symposium with Johns Hopkins University Center for School Health and Attendance Works in Washington, DC. More than 127 leaders from the fields of health, education, and public health met, with nearly 1,000 more joining virtually, to advance strategies to approach student chronic absence as a shared outcome for health and education.
More than one in four children in the U.S. are chronically absent, defined as missing 10% or more of their school days, putting their long-term learning health, development, and economic prospects at risk. The All in for Attendance event was convened out of the recognition that chronic absence is not solely an education issue and a cross-sector approach is needed to address this challenge.
Participants were presented with practical, collaborative strategies to address chronic absence in their own communities. A joint white paper outlining a public health approach for addressing chronic absence was also published. The white paper focuses on 3 core principles:
- Use school attendance data as a vital sign of student and system well-being to drive action
- Develop strategic partnerships to align goals and drive progress on chronic absence
- Develop strengths-based policies and programs to promote school attendance and prevent chronic absence
Cross-sector Call to Action
Addressing chronic absence as a public health challenge will help bring new partners, leverage data to guide action and encourage prevention-focused, cross sector strategies.
The day started with a fireside chat, hosted by Dr. Josh Sharfstein, director of the Bloomberg American Health Initiative at Johns Hopkins Bloomberg School of Public Health. Dr. Sharfstein introduced the concept of school attendance as a public health issue and the need for responding with a public health approach. He emphasized that public health approaches have been effective in addressing other complex issues, like food insecurity and tobacco cessation.
Dr. Sharfstein welcomed the perspectives of Bechara Choucair, executive vice president and Chief Community Health Officer for Kaiser Permanente and Chris Morphew, dean of the Johns Hopkins School of Education, to present a call to action for chronic absence as a vital sign.
Dr. Choucair acknowledged that student absence is one of the earliest and clearest indicators that a student may be struggling, sharing that school attendance data can be used as an early warning signal to identify where support is needed to individuals and systems, and to monitor progress. Because we know that physical and mental health challenges are some of the primary reasons students miss school, Dr. Choucair underscored the significance of Kaiser Permanente’s role as a health care system in addressing health-related drivers of chronic absence in collaboration with schools. Attendance data is an important early warning indicator that can be used by multiple sectors to drive their own action as well as cross-sector collaboration. Dr. Choucair pointed out that “the stakes are too high with chronic absence to assign responsibility to any one sector. This is going to take all of us.”
Youth Voice
Engaging youth in the development and implementation of strategies to address chronic absence is key to effective solutions. Youth encourage adults to consider all the factors that could be impacting attendance.
Members of the Kaiser Permanente National Thriving Schools Youth Council (Amy X. and Thomas A.) joined youth leaders from HeartSmiles (Imani S. and Michell F.), a youth-serving organization in Baltimore for a midday plenary entitled: Cool Kids Show Up: A Youth Conversation on Health, Support and Attendance. Facilitated by Dionte McClendon, lead consultant of Unlearning Youth, the youth panelists shared examples when they and their peers have found it hard to get to school regularly due to physical and mental health issues and the impact that missing a lot of school can have.
The youth leaders encouraged adults to consider all the factors that could be hindering attendance rather than assuming a student is lazy or other negative assumptions. The panel also provided design ideas for a program or policy that could help students show up to school. For example, enhancing a school’s drop-off program to support parents who are having difficulty getting their child to school on time; or providing mental health “kits” with stress balls and other coping supplies to help students struggling with anxiety in school.
Early Indicator Strategy Session
Chronic absence can serve as a powerful early warning indicator of student and system-level needs.
In the afternoon, Annie Reed, executive director of youth and school engagement for Kaiser Permanente, led a breakout session that explored how chronic absence can serve as an early warning indicator of student and system-level needs. The session highlighted bright spots from both the education and health sectors on how attendance is being used as a vital sign.
Panelists included Dr. Eva Stone, manager of district health services at Jefferson County Public Schools in Louisville, Kentucky, Dr. Jessica Weisz, general pediatrician at Children’s National Hospital, and Alex Zepeda, senior data and research manager at the Los Angeles Trust for Children’s Health. Each panelist gave an overview of how they are using chronic absence data to determine populations in need of additional support resources. Attendees in the session were given time in small group discussions to identify challenges, opportunities, and partnerships needed to operationalize attendance through cross-sector collaboration.
The All in for Attendance symposium was just one of the first steps demonstrating Kaiser Permanente Thriving Schools’ commitment to transform how education and health/public health systems engage with each other to drive improved health outcomes for students, staff and teachers.
A key priority for Thriving Schools is to ensure school districts know how to use their data to address the health-related drivers of chronic absence and can implement prevention programming and early interventions that ensure students are healthy and ready to learn. Kaiser Permanente is also exploring opportunities the health sector can play in strengthening the role it plays in addressing chronic absence.
To learn more about how we’re helping to support districts and align efforts around this issue, read our blog post Cross-district Learning: Addressing Health-Related Impacts of Student Chronic Absence or contact us.
