A recent study led by researchers at UCLA Health has found that children who experience adverse childhood experiences (ACEs) are much more likely to miss school because of health problems.
Using data from a national survey, the study showed that even one ACE nearly doubles the chance of chronic absenteeism caused by illness, injury, or disability. The research was published in the journal Academic Pediatrics.
School absenteeism has risen sharply since the COVID-19 pandemic. Missing too much school is known to predict poor health, education, and economic outcomes later in life.
The study highlights how early trauma—such as exposure to violence, neglect, or racism—can affect school attendance not only through family or behavioral issues but also through worsening health. Addressing these health impacts could help improve attendance and long-term success for children.
Researchers analyzed responses from over 10,000 parents of children aged 6 to 17 from the 2021–2022 National Health Interview Survey. They looked at seven types of ACEs, the child’s health status, and the number of school days missed due to health reasons in the past year.
Using statistical models, the team found that about one in four children had experienced at least one ACE. These children were 1.5 times more likely to miss any school due to health issues and 2.4 times more likely to miss a large amount of school (chronic absenteeism) for health reasons. The risk increased by 25% with each additional ACE.
While poorer general health explained part of the link between ACEs and absenteeism, other factors related to physical and social stress also played a role. Among specific ACEs, witnessing violence and facing racial discrimination were most strongly linked to chronic health-related absences.
The findings suggest that pediatricians and educators should work together to identify children affected by ACEs and provide support early, especially when health-related absences start to occur.
Health systems might consider screening for ACEs and coordinating with schools to reduce absenteeism and improve children’s well-being. The researchers also recommend future studies using detailed school attendance and health data to better understand the causes.
“This study confirms what pediatricians have seen for a long time: children exposed to adversity face many challenges in both clinics and classrooms,” said Dr. Rebecca Tsevat, lead author and pediatrician at UCLA Health.
“We need new ways for schools and health care to collaborate. This will help support students before they miss too much school and face worse health and education outcomes.”
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