PROVIDENCE – When one looks at the epidemiologic data from the 20^th century, one of the greatest improvements in public health outcomes was the result of regulations banning smoking indoors. In Rhode Island, Pat Nolan, the former director of the Department of Health, deserves credit.

These regulations, along with improvements in regulations mandating cleaner water, cleaner air, and better regulations protecting us from toxic and chemical pollution, have made a profound difference in public health.

When it comes to smoking, after decades of denial, the corporations behind the tobacco industry admitted their liability for their promotion of their dangerous, addictive products – even if much of the money from tobacco settlements was never ever used for its intended purposes, public education about the dangers of smoking.

The recent public relations campaign launched by Gov. Dan McKee and his state education commissioner, Angélica Infante-Green, to address chronic absenteeism in Rhode Island’s public schools, has created all kinds of new data dashboards to track the incidents of chronic absenteeism – with lots of bells and whistles. But it is doomed to fail. Why? Because the causes of chronic absenteeism have been linked to asthma and childhood lead poisoning – causes not addressed by the Governor.

At a news conference held on Thursday, Nov. 2, at the Stephen J. Olney Elementary School in North Providence, Commissioner Infante-Green gave voice to the slogan that she believes will transform student attendance issues: “Attendance matters and it is cool to be in school,” as quoted in the subsequent news release put out by the Governor’s office. To quote the intrepid WPRO news anchor and reporter, Steve Klamkin: “Really?”

ConvergenceRI reached out to a number of community advocacy groups, including Childhood Lead Action Project, RI KIDS COUNT, the R.I. Department of Health, and Dr. Peter Simon, retired pediatrician and former medical director at the R.I. Department of Health. What ConvergenceRI was searching for was the most recent data that showed how chronic absenteeism in public schools was linked to asthma and lead poisoning – two conditions that had been left out of the data tabulations in the Governor’s new dashboards. Why was that?

In addition, ConvergenceRI dug back into the digital archives of ConvergenceRI, re-reading more than half a dozen stories that had reported on how chronic absenteeism was definitely linked to asthma and lead poisoning.

The stories included: “Drawing a line in the sand, with the deadline of 2025,” “Poisoning the future of RI Children,” and “Blinded by the lead.” [See links below to ConvegenceRI stories.]

Translated, the data showed the evidence: the major causes of chronic school absenteeism are asthma, caused by air pollution from highways and poor housing conditions, and childhood lead poisoning.

As Brenda Clement, executive director of HousingWorks RI, said in 2016: Affordable housing is connected with good health, lower medical costs, job stability, and for children, the ability to do well at school. Once you take away someone’s ability to live in a safe, affordable home, she continued, “Everything else in their lives starts to unravel.”

Here’s the evidence, Governor

Finding the evidence and the data to back up the fact that chronic school absenteeism is directly linked to cases of asthma and childhood lead poisoning was not that difficult to find, if you know how to ask questions – and do not become deluded into thinking that you can find your misplaced keys to your car under a street light, because that is what is shining in the darkness.

Here are the data, from the “Educational Impacts of Lead Exposure,” published by the Rhode Island Longitudinal Data System, housed at the University of Rhode Island, originally published in September of 2020 and updated in February of 2021. [See link to study below.]

EVERY YEAR, thousands of children are exposed to the dangers of lead in their own homes. Lead exposure affects a child’s ability to grow, think, learn, relax, and form critical early bonds; these impacts on a child’s educational outcomes are substantial. In this story, we will explore lead exposure among Rhode Island children and examine its impacts on various educational measures.

LEAD EXPOSURE impacts a child’s ability to obtain a good education and succeed in school. Common sources of lead include paint, dust, and drinking water. Lead can affect how a child’s brain develops, making it difficult for a child to learn.

LEAD CAN BE A MARKER for a variety of unhealthy housing conditions that can affect not only a child’s ability to learn, but also whether a child is healthy enough to attend school at all.

As exposure to lead increases, so does student absenteeism. Families encounter a number of challenges when they are exposed to unhealthy environmental conditions. Unhealthy housing can be associated with chronic sickness in children keeping them out of school. Research finds that asthma contributes to higher levels of absenteeism. Concurrently, lead exposure has been found to be a reliable proxy for unhealthy environmental conditions that exacerbate asthma. 

Grade retention also increases with increased exposure to lead. Grade retention refers to the number of students who are “held back” and asked to repeat a year of school. Given the cognitive and developmental delays linked to elevated BLL [blood lead levels] in children, we would expect to see an association between BLL and grade retention.

In the 2018-19 school year 9 percent of all students in the lowest BLL category had ever been retained as opposed to 12 percent of students in the highest BLL category.

While grade retention is intended to give struggling students additional time and support to master grade-level goals, studies show mixed results on academic performance. Additionally, research has shown retained students to be more likely to have a myriad of social, behavioral, and emotional problems in the future. Grade retention is one of the most powerful predictors of dropout status and is linked to lower future earnings.

The linked data analysis clearly shows an association between lead exposure and lower state assessment scores, higher rates of absenteeism, grade retention, and increased IEPs [Independent Education Plans].

Children who test below proficient on the state assessments may find it harder to graduate from high school. The need to stay home from school or repeat a grade can also affect a child’s quality of life and potential to succeed.

Costs of lead poisoning, such as special education costs, lost future earnings, or other costs associated with compromised health, may put a strain on parents and families as well as the fiscal health of the state.

These results provide evidence that lead exposure can substantially impact the lives of children in Rhode Island.

More data, Gov. McKee
While it is not as recent as the report on “Educational Impacts of Lead Exposure,” the health data book produced by the R.I Department of Health in 2014 found that more than 37 percent of children with asthma were considered chronically absent based on data from the school years covering the 2009-2010, 2010-2011, 2011-2012, and 2012-2013 school years. [See link below to the report.]

The data from the report showed the following findings:

•           For children asthma can lead to missed school days, causing them to fall behind in their studies. If unabated, these issues can reduce a child’s long-term economic and social wellbeing.
•           Chronic absenteeism is defined as having missed 10 percent or more of total school days enrolled within a school year.
•           There were 18,022 children identified with asthma who were enrolled in a public or charter school at some time between the 2009-10 and 2012-13 school years. Of those 18,022 students, 6,744, or 37.4 percent, were chronically absent in at least one of the school years.
•            Areas with the highest rate of chronic absenteeism among children with asthma may reflect the existence of other disadvantages.