Chronic absence is one of the most pressing challenges facing schools, shaping not only district financial stability and academic outcomes, but students’ long‑term health and life opportunities. National data shows that 23.5% of U.S. students were chronically absent during the 2023–24 school year, nearly double pre‑pandemic levels. When nearly 1 in 4 students miss at least 10% of the school year, the consequences ripple across classrooms, families, and communities.
While students miss school for many reasons, illness and other health-related challenges consistently rank among the leading causes of absenteeism and are the primary reason students miss school. Physical conditions such as asthma or acute illness, mental health concerns like anxiety or depression, and social health factors — including transportation barriers and housing instability — all play a role. These patterns make attendance a powerful early warning sign: when students are chronically absent, it often signals unmet health needs or underlying social determinants that require attention.
Attendance as a Vital Sign Initiative
Attendance as a Vital Sign is Kaiser Permanente’s commitment to align the health and education systems to jointly address the health-related causes of chronic absence with a proactive, cross-sector approach. As a health care system with deep experience partnering with school districts and education systems across the country to support healthy schools, Kaiser Permanente is uniquely positioned to advance this work. We know improving attendance requires coordinated action on two fronts.
- Advancing Data-Driven Decision-Making in the Education System
School districts need better tools and data to move from tracking attendance to understanding it.
Although all school districts track student attendance, simply counting absences does not tell the full story. Districts are rarely equipped to identify the root causes of chronic absence and intervene accordingly. This is especially true for the health factors contributing to student chronic absence. For example, consider a student experiencing anxiety about attending school. They may miss multiple days, gradually becoming chronically absent. But without visibility into the underlying cause, those absences are simply recorded – not understood or addressed.
Clarifying the reasons students are absent through improving data collection and reporting is critical at a time when fiscal constraints and workforce shortages are impacting school districts’ ability to meet student health needs. Understanding the specific health reasons students are missing school can help school districts more effectively utilize the limited resources they have to support student health and wellness, which improves attendance. This data can also help engage community-based partners, including health care and public health, to help meet student health needs at schools.
Our strategy provides direct coaching and resources for school districts to work with their local healthcare partners, encourages using publicly available data sources, and emphasizes collecting and using improved data to identify the root causes of chronic absence in their district.
- Catalyzing Change in the Health System
The health system must play a more active role in addressing absence. Kaiser Permanente recognizes that school districts cannot shoulder this work alone. As detailed in “All in for Attendance: Collective action for public health strategies that address chronic absence,” a framework co-published with Johns Hopkins Bloomberg School of Public Health and Attendance Works, chronic absence is identified as a public health challenge.
Not only can health care and public health organizations partner with school districts to support strategies that address the health-related causes of chronic absence, but pediatric clinicians can use information on student attendance as an early warning sign of unmet health needs in children and families. For example, a pediatrician may treat a child for uncontrolled asthma without realizing that same condition contributes to frequent school absences.
A core component of Kaiser Permanente’s Attendance as a Vital Sign initiative is advancing efforts within health systems to both support school districts in addressing attendance and equip clinicians with the tools and training needed at the point of care to support families experiencing chronic absence. Kaiser Permanente is excited to partner with American Academy of Pediatrics (AAP) on this work. Increasing the practice of screening for chronic absence during well-child visits and providing pediatricians with best practices and actionable resources when a family screens positively for chronic absence can address the root causes of absence.
Chronic absence is not solely a challenge within schools; it is a shared responsibility. By aligning health and education systems, Kaiser Permanente is working to remove preventable barriers to attendance and strengthen the health and well-being of the entire school community. We are at the early stages of this effort and look forward to sharing insights and progress as we continue advancing this work alongside our partners. Together, we have an opportunity to reimagine what’s possible when whole-school health becomes a collective priority.
