Rising Health Risks for School-Refusing Children Highlight Urgent Need for Systemic Change

by Krystal

In a troubling trend, children who avoid school are increasingly facing serious health issues due to missed medical checkups. This gap in healthcare can lead to long-term disabilities if left unaddressed. Despite legal requirements for schools to conduct health screenings, inconsistent follow-up protocols are failing to catch issues for students who are frequently absent.

Mari Saikusa, a 29-year-old graduate student in Kita-Kyushu researching the health impacts of truancy, is a prime example. Saikusa, who suffers from moderate scoliosis—a condition causing her spine to curve—has experienced significant back pain. Her condition was not diagnosed until later in life, partly due to her irregular school attendance during her younger years.

“Had my scoliosis been detected during school health checkups, early intervention could have prevented the severity of my condition,” Saikusa reflects. Her scoliosis, which now requires ongoing management at an orthopedic rehabilitation center, was never identified because she rarely attended school from third grade through junior high. The absence of regular medical evaluations during this period contributed to her current health challenges.

Saikusa also encountered significant dental issues, which she attributes to missed checkups during her school years. A visit to the dentist later revealed severe tooth decay that required extensive treatment, further underscoring the impact of missed health screenings.

Her research, conducted as part of her academic work, surveyed 225 students with histories of school absenteeism. The findings revealed that 84 students “almost never” received school medical checkups, while 61 received them sporadically. Only 26 students reported regular checkups.

The lack of consistent health evaluations has left many students unaware of critical issues like vision impairments. Saikusa argues that children should not miss out on essential medical care simply because they do not attend school regularly. She advocates for a more flexible approach to health checkups that extends beyond the school environment.

Despite common perceptions that parents are to blame for missed school checkups, Saikusa emphasizes the broader systemic issues. She explains that her own parents were overwhelmed with managing multiple responsibilities and were not able to focus solely on school health screenings.

The education ministry reports a record high of approximately 299,000 students refusing school attendance in fiscal 2022, marking a 20% increase from the previous year and continuing a decade-long upward trend. Under the law, schools must conduct health checkups by the end of June each year, covering a range of issues from malnutrition and dental diseases to spinal and hearing impairments.

However, there is no standardized protocol for addressing the needs of students who miss these checkups. Some schools attempt to inform students about checkup opportunities at nearby institutions, while others provide alternative dates for missed evaluations.

In response to these challenges, Suita City in Osaka Prefecture has implemented a uniform system allowing students to receive checkups at designated medical and dental clinics from July through September. This initiative, funded by an annual budget of approximately 500,000 yen ($3,430), has seen some success, with 133 students receiving internal medicine checkups and 139 undergoing dental evaluations last year.

Similarly, the Yokohama-based nonprofit organization Tanpopo is advocating for a system that permits truant children to access free health checkups outside of school. The group highlights the inadequacies of current provisions, noting that approximately 8,000 students missed medical checkups and 9,900 missed dental evaluations in fiscal 2023.

Momoki Ichinose, Tanpopo’s director, criticizes the lack of administrative action and calls for better systems to address the needs of truant students. Discussions are ongoing with local medical associations to explore potential solutions.

The education ministry’s health education division acknowledges the issue but lacks detailed statistics on the extent of missed checkups. They maintain that schools should address these challenges based on individual circumstances.

As the number of children missing school continues to rise, the need for a comprehensive, inclusive approach to health checkups becomes increasingly urgent. Ensuring that all children, regardless of school attendance, have access to necessary medical care is crucial for their long-term well-being and development.

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