This time of year presents many challenges to getting to school: Some days there is too much snow or rain, making it hard to catch the bus or get through the traffic. Other days students are home in bed because of head colds, coughs and the flu. Although sick children stay home with an excused absence, what many parents and schools may not realize is that even when absences are excused, missing too much school can lead children to fall behind. They also may not recognize that some health-related absences are unnecessary and preventable.

Today we know that at least 7 million students are chronically absent, meaning they miss 10 percent or more of school days – or as few as two days a month. This may not seem like much, especially in the early grades. Yet we have seen that starting as early as kindergarten and preschool, a child who misses too many days will struggle to read well, do math and develop the social skills needed to succeed in school.

In fact, students with high numbers of absences are much more likely to drop out of high school. By ninth grade, missing too many days of school is a better indicator that a student will drop out than eighth-grade test scores. This is especially true for those students living in poverty who need school the most and are sometimes attending the least.

Many of these absences— especially among our youngest students—are excused and tied directly to health factors affecting children or other family members. But missing school because of illness isn’t just a winter occurrence. Excused absences from untreated asthma and dental problems, learning disabilities, and mental health issues related to trauma and community violence also keep students from attending school.

Children and adolescents will get sick at times and may need to stay at home. It’s our job to help minimize the number of days a student misses school.

Which Illnesses Keep Kids Home?

Many families don’t realize how important it is for children to attend school every day possible. They may pull children out of school to go to the doctor or to extend a family vacation. What’s more, some children complain of a stomachache when they are actually nervous about going to school, a sign of school aversion that is hard to recognize. Bullying at school or on the way to school can lead a child to ask to stay home. Others might have an undiagnosed learning disability and feel that they can’t do well.

When it comes to illness, asthma and dental issues are the top two health conditions that keep students from being in class. As we write in Mapping the Early Attendance Gap, asthma accounts for about 14 million absences each school year, or one-third of all days of missed instruction. Children with persistent asthma are more than three times as likely to have 10 or more absences than their peers.

Perhaps surprisingly, among school-age children, tooth decay is the most common chronic disease, and is five times more prevalent than asthma. Children with poor oral health are nearly three times more likely than their counterparts to miss school as a result of dental pain.

These two health issues are the tip of the iceberg. Research indicates that other common health conditions resulting in missed school include Attention Deficit Hyperactivity Disorder (ADHD), diabetes, obesity, mental health and anxiety, and vision problems. Health-related factors such as food insecurity, unhealthy housing, and violence in the community also play a significant role.

We also know that there are lots of things families can do that help keep children healthy. Parents can help their child by making sure they get enough sleep, eat healthy meals, and exercise so kids stay in good health and boost their resistance to disease.

What Can Schools Do?

The good news is that absences related to health issues can be minimized. Districts, schools, teachers and health providers are addressing chronic absence by helping students obtain health related guidance and services. In Charlevoix, Michigan, for example, the Munson Healthcare Charlevoix Hospital partnered with the school district to fund full-time school nurses. By teaching handwashing, developing health management plans for individual students, and engaging with teachers about health, the district has seen a significant and sustained decrease in chronic absence.

Students who eat breakfast at school attend an average 1.5 more days of school every year. School-based breakfast programs particularly help students from low-income communities who are eligible to receive free or reduced price breakfast. Studies about Playwork s show that a quality recess environment helps students experience less bullying, feel safer at school, and deepen relationships with caring adults. Kaiser Permanente’s Thriving Schools initiative promotes good nutrition and exercises with resources boost health for students, staff, and teachers.

What Can Parents Do?

Paying attention to students with health issues and finding out why they occur can help families and schools make sure students continue to learn and build a habit of regular attendance. As a parent, you can take simple steps to ensure your sick child is not missing too much school:

1. Find out what day school starts and make sure your child has the required shots. Some children miss school simply because they don’t have the immunizations required for enrollment.
2. If your child has a chronic disease, make sure that the school staff is aware of the disease so they can assist your child if he or she becomes ill.
3. Don’t let your child stay home unless she is truly sick. Our How Sick is Too Sick handout can provide guidance for when a child can return to school. Keep in mind complaints of a stomach ache or headache can be a sign of anxiety and not a reason to stay home.
4. If your child seems anxious about going to school, talk to teachers, school counselors, or other parents for advice on how to make her feel comfortable and excited about learning.
5. Arrange medical appointments outside of when school is in session.
6. Make sure your children get enough sleep, have healthy meals, and exercise.
7. Ask your school to consider engaging the school nurse or health provider to support attendance by calling home when students miss school. Learn more about how health care provider s can participate in improving attendance their schools.
8. Make sure your school is paying attention to all the right data. The school’s chronic absence data and your own experience with fellow parents can reveal what’s keeping kids from getting to school, whether it’s chronic asthma or a dangerous walk to school.
9. Educate parents at your child’s school: Talk to other parents in your school about the importance of attendance for every student’s success and who to call for the health service resources. Consider launching a “walking school bus” that gathers children in your community for a safe walk to school.
10. Celebrate Attendance Awareness Month in September. Attendance Works has free posters, banners, badges and tip sheets that you or parents in your community can download to help promote good attendance.

*Disclaimer: This piece is not meant to replace advice or recommendations from a medical professional. If you have any questions about your child's health, please seek advice from a doctor.