title: Assessing the connection between health and education: identifying potential leverage points for public health to improve school attendance.
abstract: OBJECTIVE
  We examined multiple variables influencing school truancy to identify potential leverage points to improve school attendance.
  
  
  METHODS
  A cross-sectional observational design was used to analyze inner-city data collected in Los Angeles County, California, during 2010 to 2011. We constructed an ordinal logistic regression model with cluster robust standard errors to examine the association between truancy and various covariates.
  
  
  RESULTS
  The sample was predominantly Hispanic (84.3%). Multivariable analysis revealed greater truancy among students (1) with mild (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI] = 1.22, 2.01) and severe (AOR = 1.80; 95% CI = 1.04, 3.13) depression (referent: no depression), (2) whose parents were neglectful (AOR = 2.21; 95% CI = 1.21, 4.03) or indulgent (AOR = 1.71; 95% CI = 1.04, 2.82; referent: authoritative parents), (3) who perceived less support from classes, teachers, and other students regarding college preparation (AOR = 0.87; 95% CI = 0.81, 0.95), (4) who had low grade point averages (AOR = 2.34; 95% CI = 1.49, 4.38), and (5) who reported using alcohol (AOR = 3.47; 95% CI = 2.34, 5.14) or marijuana (AOR = 1.59; 95% CI = 1.06, 2.38) during the past month.
  
  
  CONCLUSIONS
  Study findings suggest depression, substance use, and parental engagement as potential leverage points for public health to intervene to improve school attendance.
authors.affiliation: Lauren N. Gase is with the Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, and the Clinical and Translational Science Institute, University of California, Los Angeles. Tony Kuo is with the Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, and the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles. Karen Coller, Lourdes R. Guerrero, and Mitchell D. Wong are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Gase
authors.forename: Tony
authors.initials: T
authors.lastname: Kuo
authors.forename: Karen
authors.initials: K
authors.lastname: Coller
authors.forename: Lourdes R
authors.initials: LR
authors.lastname: Guerrero
authors.forename: Mitchell D
authors.initials: MD
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D010287:Parent-Child Relations; D011634:Public Health; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data*