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Education is a central determinant of adolescent health. School absences and bullying involvement jeopardize educational attainment. We analyzed time trends in school absenteeism over two decades and examined the association of absenteeism with bullying involvement. We analyzed data from the nationwide School Health Promotion study, with self-reported data from Finnish middle school students in grades 8 and 9 (ages 14–17, N = 1 000 970). Questionnaires assessed frequency of illness absences (IA), truancy, frequency of bullying victimization (BV), bullying perpetration (BP), and involvement in both bullying perpetration and victimization (BPV). Frequent school absences were defined as occurring at more than 3 days during the prior month (2000–2015), or least weekly (2017–2019). Frequent IA increased from 12% in 2000 to 22% in 2015. In 2017–2019 frequent IA was reported by 3.5%. Frequent truancy declined from 9% in 2000 to 4% in 2015, and 2017–2019. BV was reported at least weekly by 6.9%, BP by 5.4% and BVP by 1.9% of participants. In a logistic regression model, all kinds of bullying involvement increased odds for both IA and truancy. Since bullying involvement was associated with both IA and truancy, particular concern should be raised for adolescents involved in bullying, and for their social and educational functioning. The concurrent increase in IA and decrease in truancy may reflect destigmatization of mental health problems or other changing patterns in reporting absenteeism.

Purpose of the studySchool absenteeism and school dropout jeopardize the future health and wellbeing of students. Reports on the participation of school health care in absenteeism reduction are infrequent, although physical and mental health problems are the most common causes of school absenteeism. Our aim was to explore what reasons different professionals working in schools recognize for absenteeism and which factors either promote or inhibit the inclusion of school health care in absenteeism reduction.Materials and methodsData for this qualitative study was gathered from ten focus groups conducted in two municipalities in southern Finland. The groups included (vice) principals, special education/resource/subject teachers, guidance counselors, school social workers, school psychologists, school nurses, school doctors, and social workers working in child protective services. Data analysis was predominantly inductive but the categorization of our results was based on existing literature.ResultsStudy participants identified student-, family-, and school-related reasons for absenteeism but societal reasons went unmentioned. A number of reasons promoting the inclusion of school health care in absenteeism reduction arose, such as expertise in health-related issues and the confidentiality associated with health care. Inclusion of school health care was hindered by differences in work culture and differing perceptions regarding the aims of school health care.ConclusionProfessionals working in schools were knowledgeable about the different causes of school absenteeism. Clarifying both the aims of school health care and the work culture of different professionals could facilitate the inclusion of school health care in absenteeism reduction.