Factors Associated with School Absence Among Children with Symptomatic Asthma, United States, 2002–2003

Children with asthma miss nearly 13 million school days annually due to asthma. We sought to examine risk factors for asthma-related school absence among children with symptomatic asthma to discern risks uniquely associated with symptomatic asthma. We analyzed 2002–2003 National Health Interview Survey data for children ages 5–17 years with symptomatic asthma ( N = 905), that is, those with a reported asthma diagnosis and ≥1 asthma attack(s) in the previous year. Among the population of children with symptomatic asthma, we used logistic regression to assess the association between risk factors and asthma-related school absences. We also examined nonasthma absences among this population to assess if risk factors for asthma-related absences differed from those for other absences. Finally, we examined absences among children without asthma for comparison. A greater proportion of children with symptomatic asthma missed school compared with children without asthma. Overall, 59% of children with symptomatic asthma had ≥1 asthma-related absence in the past year. Among this group, presence of an adult household smoker was associated with an increased adjusted risk ratio for asthma-related school absence [adjusted risk ratio = 1.25 (1.10, 1.42)] as were race/ethnicity other than non-Hispanic white, low parental education, and reported health status less than “very good/excellent.” Greater asthma healthcare resource use (emergency department visits and preventive medication use) were also associated with higher risk. For nonasthma-related absences among children with symptomatic asthma, only having no usual source of healthcare emerged as a risk factor. Exposure to an adult household smoker and greater asthma healthcare use were associated with ≥1 asthma-related school absence among children with symptomatic asthma. Asthma-related school absences may help identify children in greater need of asthma evaluation and management.