The Association of Obesity and School Absenteeism Attributed to Illness or Injury Among Adolescents in the United States, 2009

Abstract

Purpose-School attendance can impact academic performance. Childhood obesity-related physical and psychosocial consequences are potentially associated with school absenteeism. Thus, we examined the association between school absenteeism attributed to illness or injury and obesity among adolescents aged 12-17 years.Methods-We used a weighted sample of 3,470 U.S. adolescents from the 2009 National Health Interview Survey. School absenteeism was measured from the parent-reported number of sick days taken in the preceding 12 months. Body mass index was calculated from parent-reported weight and height. Weight status was classified based on the sex-specific body mass index-for-age percentile defined by the CDC growth charts. Poisson regression was conducted to examine the association between school absenteeism and weight status, controlling for selected sociodemographic characteristics and disease status.Results-The mean number of annual sick days was 3.9 days overall; 3.4 days among normalweight, 4.4 days among overweight, and 4.5 days among obese adolescents. Obese adolescents had a higher proportion of missing ≥4 days of school per year than adolescents of normal weight. Our multivariate analyses found that compared with adolescents of normal weight, overweight and obese adolescents had greater than one-third more sick days annually (rate ratio = 1.36 for overweight and 1.37 for obese adolescents).Conclusions-Overweight and obese adolescents had 36% and 37% more sick days, respectively, than adolescents of normal weight. The results suggest another potential aspect of obesity prevention and reduction efforts among children and families is to improve children's school attendance. KeywordsBody mass index; Obesity; School absenteeism; School attendance; Adolescents HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThe United States has increasingly recognized that childhood obesity is a major health problem among the nation's youth. Using measured weight and height, the National Health and Nutrition Examination Survey (NHANES) documented tripling of the prevalence of obesity among adolescents aged 12-19 years, increasing from 5.0% to 18.1% between 1976-1980 and 2007-2008. The sharpest increase in prevalence occurred between 1976-1980 and 1999-2000, with no significant increasing trend from 1999-2000 to 2007-2008 [1-3].Childhood obesity can affect physical and psychosocial health. For example, obesity is related to reduced quality of life and comorbidities, such as diabetes, hypertension, and metabolic syndrome, among children and adolescents [4][5][6][7]. In addition, childhood obesity may cause negative psychological and social consequences, such as depression, lower selfesteem, social isolation, and stigmatization [8][9][10][11]. These comorbidities and consequences may affect other aspects of children's lives, such as increasing their school absenteeism, which could lead to lower academic performance [12][13][14]. Given the high obesity prevalence, many U.S. childr...

Association of overweight and obesity with decline in academic performance among female high-school students, Riyadh, Saudi Arabia

“…Several explanations have been suggested for the negative association between BMI and academic performance. These include higher rates of healthrelated school absenteeism (25), reduced cognitive function (26), negative impact on self-esteem (9), concurrent depressive symptoms (8), and finally, peer and teacher prejudice (14,18). However, such a negative association was shown in previous studies to be independent of depressive symptoms, intelligence quotient (IQ) and several sociodemographic characteristics (12,13).…”

Health Status and Residential Exposure to Air Toxics

“…1,2 Studies examining the relationship between children’s subjective health status and academic achievement have consistently found that poorer health status is associated with worse academic achievement outcomes. 3,4 When children are unhealthy, they may have more difficulty learning than their healthy counterparts and have poorer academic achievement outcomes.…”

Effects of statewide health promotion in primary schools on children’s sick days, visits to a physician and parental absence from work: a cluster-randomized trial

“…Another study from the US examined more than 165,000 students in grades 1–12 and found only weak associations between obesity and increased school absences [7]. A national survey in the US of 3470 adolescents reported overweight and obese pupils aged 12–17 years of having 36 and 37% more sick days, respectively, than their normal-weight peers [8]. Among 1387 US children (6–11 years) and 2185 adolescents (12–18 years) a relationship between severe absenteeism and weight status was found only in children but not adolescents [9].…”