Effect of Asthma and Air Quality on Missed School Days: Findings from the Asthma 411 School Initiative

According to 2014 CDC estimates, about 1 in 11 children have asthma. Asthma accounts for about 9 million doctor visits and costs $56 billion yearly.

Using data from the Fort Worth Independent School District, this study quantifies the relationship between asthma status and school absences; and examines the association between exposure to poor ambient air quality and missed school days.

Methodology

Data (N = 1628) including the number of school days missed and attended, actual absence dates, and student demographics were collected from one elementary and one middle school in Fort Worth, Texas. Counts of sets of consecutive missed school days were modeled using negative binomial regression; the relationship between proportion of missed school days and asthma was assessed using multivariable linear regression; and partial correlation analysis is being used to identify the relationship between exposure to poor ambient air quality and missed school days. All analyses are conducted using SAS 9.3.

Results

For both count models analyzed, children with asthma have rate ratios of 1.26 (p-value = .050) and 1.24 (p-value = .098) for sets of consecutive missed school days. Adjusting for demographic variables, children with asthma miss, on average, 30% more school days that those without asthma (p-value <.01). We hypothesize a positive correlation between absences and poor ambient air quality, with a lag period of 2 days, although we will also evaluate lags of 0, 1, and 3.

Conclusion

Policies are needed to reduce the impact of asthma on children’s school experience, such as measures to strengthen school asthma services and reduce exposures to environmental triggers.