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Chronic Absenteeism Reduction Effort

Chronic Absenteeism Reduction Effort

Rx for Chronic

Over 6 million kids in the U.S. miss 15 or more days of school a year, according to federal data. This chronic absenteeism negatively affects educational achievement and long-term health outcomes. 


The Chronic Absenteeism Reduction Effort (CARE) Playbook can help health care systems and school districts work together to get students in classrooms and ready to learn.

Education and Health are Intricately Connected

The impact of chronic absenteeism can reverberate throughout a student’s life.

School Attendance Matters

Children and youth who attend school regularly are more likely to read on grade level, have stronger academic outcomes, and graduate on time. Missing too much school in early grades can lead to below grade-level reading in third grade, a key predictor of high school graduation.

Absenteeism Can Lead to Long-Term Health Risks

People without a high school diploma have greater health risks as adults and may live shorter lives.

Data on Absenteeism Can Empower Healthcare Providers

Healthcare providers can help students attend school regularly by addressing health and social issues that are keeping students out of school. However, often healthcare providers don’t know that students are missing too much school.

There was a student with asthma who was hospitalized with COVID-19, which was part of what was keeping him out of school. With support from an outreach coordinator, the family scheduled a visit with their primary care provider and made sure the student had the medicine and paperwork he needed to get him back into the virtual classroom. He hasn’t had an absence since.

Healthcare Provider participating in CARE

CARE in Action

Using data to help healthcare providers address chronic absenteeism in Washington, D.C.

Nearly 30% of K-12th graders in Washington, D.C., public schools are chronically absent, according to data from the D.C. Office of the State Superintendent of Education. A new project to share absenteeism data with healthcare providers is making an impact.

Absenteeism is a leading indicator of educational inequities, and a substantial proportion of school absences are connected to mental and physical health conditions, as well as socioeconomic and environmental factors.

In fact, youth of color, youth from low-income backgrounds, and youth that have experienced trauma are 4x more likely to be chronically absent.

Recognizing this critical intersection of education and health, the CARE project was developed to strengthen the connections between healthcare providers and educators by training healthcare providers about chronic absenteeism and using secure data sharing to engage providers in addressing chronic absenteeism.

Through this novel initiative — a partnership between public schools and health systems in Washington, D.C. — families consent to have their student’s attendance data shared with their healthcare providers, who then conduct outreach to families to provide resources and medical attention, as needed. Receiving absenteeism data helps healthcare providers identify students who may be behind on well-child visits and immunizations.

To date, the project has reached 40 families with students in grades K-12 across six public schools and three health centers, and continues to expand its reach and local impact on health and educational outcomes.

How CARE Works

Families Sign Up

D.C. Public Schools obtains consent from families.

Attendance Data Sharing

Schools securely share attendance data with CRISP, a health information exchange. CRISP shares attendance data with students’ healthcare providers.

Providers Take Action

Healthcare providers and their teams conduct outreach to students and families to identify health and social issues and help get kids back in the classroom.

Learn more about the project:

Read the CARE Playbook to learn how school districts and health systems can share data to keep kids in school.

Until CARE, I didn’t do a very good job of asking how many days of school children missed. Asking simple questions like ‘are you going to school?’ and then knowing how to respond is important. I had a patient who mentioned that they hadn't been to school in two months, so it's critical to have systems in place to help patients.

Healthcare Provider participating in CARE

Help Reduce Chronic Absenteeism in Your Community

The CARE Playbook recommends three key steps school districts and health systems can take to work together to reduce chronic absenteeism:

Engage and Support Partners
  • Know what drives chronic absenteeism in your area. In Washington, D.C., acute illness, asthma and transportation are key issues for students who miss school.
  • Identify who the decision makers are and how to get buy-in.
  • Engage partners and stakeholders, including families and youth.
  • Identify partners’ roles and responsibilities.
Address Legal and Technical Aspects
  • Develop consent forms to meet health and education privacy law requirements and gather parent signatures.
  • Determine how to share data and ensure information systems can communicate.
Reach Out to Reduce Barriers
  • Use the data to identify families and youth in need.
  • Identify staff and develop messaging to contact these families.
  • Identify and share resources to help families overcome barriers to school attendance, such as connections to a medical home, mental health care and food assistance.
  • Support communication among partners and stakeholders.


Read the CARE Playbook to learn how school districts and health systems can share data to keep kids in school.

Taking action to address health-related chronic absenteeism can have a powerful impact on students’ academic success and build the foundation for healthy, successful lives.

News and Updates

Podcast: How Pediatricians Are Addressing School Absenteeism

When children miss too much school it can negatively impact their health and set back their life potential.

Read more


The CARE project was made possible through collaboration between our key partners and with funding from the Bloomberg American Health Initiative and is continuing with support from United Health Foundation.

Feedback and Contact Form

Tell us how you’re addressing chronic absenteeism in your area or send us questions about how to launch a partnership between health systems and schools.