Asthma-Related School Absenteeism and School Concentration of Low-Income Students in California

INTRODUCTION Asthma is one of the leading causes of school absenteeism. Previous studies have shown that school absenteeism is related to family income of individual students. However, there is little research examining whether school absenteeism is related to school-level concentration of low-income students, independent of family income. The objective of this study was to examine whether the proportion of low-income students at a school was related to school absenteeism due to asthma. METHODS Using data from the 2007 California Health Interview Survey, a population-based survey of California households, we examined the association between attending schools with high concentrations of low-income students and missing school because of asthma, adjusting for demographic characteristics, asthma severity, and health insurance status. Schools with high concentrations of low-income students were identified on the basis of the percentage of students participating in the free and reduced-price meal program, data publicly available from the California Department of Education. RESULTS Students attending schools with the highest concentrations of low-income students were more likely to miss school because of asthma. Students from low-income families, younger students, those with more frequent asthma symptoms, or those taking prescription asthma medications also were more likely to miss school because of asthma. CONCLUSION The use of school-level interventions to decrease school absenteeism due to asthma should be explored, especially in schools with high concentrations of low-income students. Potential interventions could include school-based asthma education and disease management or indoor and outdoor air pollution control.