George Monteverdi

The frequency of a student's absence from school is directly proportionate to failing academic performance and school dropout.  The Attendance Works and Healthy Students Campaign report, Mapping the Early Attendance Gap, Charting a Course for Student Success, (September 2015) describes and validates this assertion.

Any asthma-related school absence is associated with suboptimal asthma control, less efficient use of healthcare services, household environmental triggers, and financial barriers to appropriate asthma health care services. (Joy Hsu et al, in Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors Am. J. Preventive Medicine, 2016: 51(1); 23-32)

 Additional evidence affirms the negative effect of asthma-related school absences on academic performance of students. Children with persistent asthma (i.e., suboptimal control) demonstrate a trend of performing worse on Missouri Assessment Program test scores and have more absence days compared with other students, including students with mild intermittent asthma. (Sheniz Moonie, Phd, Mario Castro, MD, MPH et al, The Relationship Between School Absence, Academic Performance, and Asthma Status, Journal of School Health: March 2008: 78; # 3; p. 140)

To restatepoorly controlled asthma increases asthma-related school absences, disrupts participation in school, and impedes academic performance.


Asthma-Related school absenteeism adversely impacts the State of California budget and is a significant loss of income for California schools. Two authoritative reports describe the magnitude of this impact.

A CA Dept. of Public Health Surveillance Report stated that in 2009,  "...there were 1.4 million asthma-related school absences in California public schools (which) correspond to $37 million dollars in school revenue losses."(Revenue Lost to CA Schools Because of Asthma-Related Absences;  Meredith Milet, ,MPH,  A.P.H.A., Epidemiologist, Californian Breathing, CA Dept. of Public Health [October 29, 2012])

For 2012, 1.5 million days of asthma-related absence for California student age populations was reported, a total cost (loss of parent wage due to work absence, cost of medical care for affected students, and loss of school income due to reduced attendance) of $3373.2 million. (State-level Medical and Absenteeism Cost of Asthma in the United States;  Tursynek Nurmagambetov, PhD, et al; Journal of Asthma; 2016 [a CDC study])

Conclusion:  Asthma-related school absences adversely affect student performance and the fiscal health of California schools and communities.

NOMINATED SOLUTIONS to MANIFEST NEEDS:                                                                                                         

"Creation and implementation of   SAMPRO™:School-based Asthma Management Program", Robert F. Lemanske, Jr,          MD et al; J  Allergy  Clin  Immunol  2016;138:711-23, demonstrates ways and means to utilize available resources to "...enhance multidirectional communication and promote better care for children with asthma in the school setting...". Implementation of this program requires resources which are available in our communities.


California pediatricians have access to skilled, dedicated experts and resources to assist in improving asthma management in California schools.

1.Every CA AAP Chapter has an Asthma Champion who can be identified by your Chapter Executives and is a resource to you. Please utilize this resource.

2.California District IX AAP is an affiliate member of the California School Environmental Health and Asthma Collaborative (SEHAC). Scott Kessler, Program Manager of California Breathing, the asthma program in the CA Dept. of Public Health, serves as SEHAC Chairperson. SEHAC has developed educational videos and other resources to help schools and parents improve asthma management and environmental health in schools and at home.  You are invited to view the resources at the SEHAC Website: As District IX AAP liaison to SEHAC, I hope I may assist you with answers to questions or link you to SEHAC.  

3.Implementation of these programs requires the collaborative efforts of school and community professionals. A template, "A Guide to Community School Health Councils", by the American Academy of Pediatrics, American School Health Association, and the American Cancer Society instructs pediatricians, schools, and communities how to develop a collaborative advisory group for this purpose. I will forward you this guide upon request.

California pediatricians, utilizing these resources, in collaboration with dedicated community colleagues, become the 'de facto'  ASTHMA CHAMPION  in the LOCAL EDUCATION AGENCY (LEA) of their community, i.e., the school district or county office of education.

Californians have expended millions of dollars and hours of labor to create arenas so that skilled athletes may 'teem' to market their entertainment services. Now California pediatricians have the opportunity to create arenas where we will team with colleagues to improve asthma management in our schools.