Asthma, absenteeism, and academic performance: Investigating the link

Asthma is the leading chronic childhood illness to date, characterized by episodes of wheezing, cough, chest pain or tightness, shortness of breath, or a combination of these symptoms. Prevalence has been steadily on the rise since 1980 contributing towards increasing healthcare costs, significant morbidity, mortality, hospitalizations, emergency room visits, activity limitations, and missed days from work and school. Morbidity and mortality from asthma disproportionately affects African-Americans compared to Caucasians. Many studies have followed the trends of asthma, along with the health care costs and implications resulting from the illness. Fewer studies have examined the impact that asthma has on the child attending school. This dissertation investigates the impact of the illness on the child with asthma's school absenteeism and academic test level achievement using data from two urban clinics and one school district in the Midwestern United States.; To begin, this dissertation presents an overall review of asthma, outlining trends of the illness in the United States. Next, clinic data from a cross-sectional study is reviewed highlighting the relationship between asthma severity level and missed days from work and school. Over the one-year evaluated, results show a direct correlation between asthma severity level and work/school days missed. Next, school district data revealed that students with asthma demonstrated significantly higher absenteeism compared with their healthy peers, particularly those with persistent asthma as determined by their respiratory symptoms. Additionally, among the absences prospectively tracked for a subgroup of those students with asthma, it was determined that over one third of the illness absences were specifically due to their asthma related symptoms. The findings of the academic study indicated a strong inverse relationship between absenteeism and academic test level performance. No differences in standardized test level performance were found between students with and without asthma. However, those students with persistent asthma were more likely to perform below proficiency on standardized tests compared with students with mild intermittent asthma. Additionally, students with persistent asthma presented with the highest absentee rates. This dissertation concludes by discussing important research gaps and key policies and interventions that aim to reduce the burden of asthma on our society.