The Association of Health-Related Fitness and Chronic Absenteeism Status in New York City Middle School Youth.

Background: Extensive research demonstrates the benefits of fitness on children's health and academic performance. Although decreases in health-related fitness may increase school absenteeism, multiple years of prospective, child-level data are needed to examine whether fitness changes predict subsequent chronic absenteeism status.
Methods: Six cohorts of New York City public school students were followed from grades 5-8 (2006/2007-2012/2013; N = 349,381). A longitudinal 3-level logistic generalized linear mixed model with random intercepts was used to test the association of individual children's changes in fitness and 1-year lagged chronic absenteeism.
Results: The odds of chronic absenteeism increased 27% [odds ratio (OR) 95% confidence interval (CI), 1.25-1.30], 15% (OR 95% CI, 1.13-1.18), 9% (OR 95% CI, 1.07-1.11), and 1% (OR 95% CI, 0.98-1.04), for students who had a >20% decrease, 10%-20% decrease, <10% increase or decrease, and 10%-20% increase in fitness, respectively, compared with >20% fitness increase.
Conclusion: These findings contribute important longitudinal evidence to a cross-sectional literature, demonstrating reductions in youth fitness may increase absenteeism. Given only 25% of youth aged 12-15 years achieve the recommended daily 60 minutes or more of moderate to vigorous physical activity, future work should examine the potential for youth fitness interventions to reduce absenteeism and foster positive attitudes toward lifelong physical activity.