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Insights
Children in day care, especially those under 3, experience more infections like diarrhea and meningitis. These illnesses in daycare settings incur moderate costs for families and society, necessitating policy revisions.
Area of Science:
- Pediatric Health
- Infectious Disease Epidemiology
- Public Health Policy
Background:
- Growing concerns exist regarding illness risks for infants and young children in daycare settings.
- Specific focus on children under 3 years old due to heightened vulnerability.
Purpose of the Study:
- To examine empirical evidence on day-care attendance and acute illness frequency.
- To assess the short- and long-term costs of day-care-associated illnesses.
- To evaluate impacts on children, day-care staff, and household contacts.
Main Methods:
- Review of empirical evidence on illness rates (respiratory, diarrhea, hepatitis A, meningitis, cytomegalovirus).
- Benefit-cost framework analysis for associated health costs.
- Assessment of risks for children, staff, and family members.
Main Results:
- Children in day care show higher rates of diarrhea, hepatitis A, meningitis, and otitis media.
- Evidence for increased respiratory illness (excluding otitis media) and cytomegalovirus is weak to moderate.
- Day-care-related illnesses impose moderate net costs on families and society.
Conclusions:
- Day-care attendance is linked to increased incidence of specific infectious diseases.
- Policy revisions for daycare health practices and parental information are recommended.
- Protecting child health and development in daycare settings requires regulatory and informational interventions.
Abstract:
Parents, pediatricians, social scientists, and policymakers have become increasingly concerned that infants and children in day care, especially those younger than 3 years of age, are at risk for morbidity associated with several types of acute illness. We have examined the empirical evidence on the impact of day-care attendance on frequency of respiratory illnesses, diarrhea, hepatitis A, meningitis, and cytomegalovirus disease in children, day-care staff, and household contacts. The short- and long-term costs of day-care-associated illnesses were assessed, wherever possible within a benefit-cost framework. Available evidence suggests that children in day care, and sometimes their teachers and household contacts, have higher rates of diarrhea, hepatitis A, meningitis, and possible otitis media than children not in day care. There is only weak or moderate evidence that children and their families are at risk for high rates of respiratory illness (other than otitis media) or cytomegalovirus infection. Taken together, the excess of these illnesses among children in day care may impose moderate net costs on families and on society. Revisions of state regulatory policy regarding health practices in day care and policy initiatives designed to provide parents with more information and authority are recommended to protect the health and development of children in day care.
