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Published on: July 27, 2018
Chronic Absence as a Public Health Priority: A Framework for Coordinated Action.
Catherine Falconer1,2, Michelle Shankar3, Beth D Marshall1
1Johns Hopkins Bloomberg School of Public Health.
The Milbank Quarterly
|June 22, 2026
Summary
Chronic absence, affecting over 25% of students, signals unmet health and social needs. A public health approach is crucial for addressing root causes and improving student well-being and educational outcomes.
Area of Science:
- Public Health
- Education Policy
- Child Development
Background:
- Chronic absence, defined as missing >10% of school time, impacts over 25% of US students post-COVID-19.
- It reflects unmet health/social needs and structural inequalities, with adverse educational, health, and social outcomes.
- Current responses frame chronic absence as an education-sector issue, limiting effectiveness.
Purpose of the Study:
- Reconceptualize chronic absence as a public health issue using interdisciplinary evidence.
- Develop a conceptual model of multilevel attendance determinants.
- Identify policy and cross-sector action implications.
Main Methods:
- Synthesized interdisciplinary evidence from education, public health, and child development.
- Applied ecological and life course frameworks.
- Developed a multilevel conceptual model of attendance determinants.
Main Results:
- Chronic absence is a signal of unmet needs and system performance, influenced by health, social, and structural factors beyond school control.
- Current approaches often overlook broader determinants by focusing on individual responsibility.
- Reframing necessitates coordinated cross-sector interventions addressing root causes.
Conclusions:
- Positioning chronic absence as a public health priority enables a more coherent, effective response.
- Key principles include using attendance data as a well-being indicator, fostering strategic partnerships, and developing strengths-based prevention programs.
- A public health shift is essential for equitable improvements in child health and education.
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