Acute gastrointestinal illness and child care arrangements

Abstract

This study uses data from the 1981 National Health Interview and the 1981 Child Health Supplement to assess the extent to which family day care homes and child care centers pose a risk of acute gastrointestinal illness among preschool children. The study uses a nationally representative sample of children 0-5 years of age (n = 4,845). Acute gastrointestinal illness was identified from parental reports of acute illness in a 2-week period. Information on type and duration of child care, as well as a variety of sociodemographic and environmental factors (e.g., crowding, seasonality), were obtained. The authors hypothesize that risk of acute gastrointestinal illness would vary by group size. Center attendees were thought to have the greatest exposure to infectious agents, followed by children in day care homes, and lastly by those receiving care in their own homes. Risk models were estimated separately for children less than 3 years of age and for children aged 3-5 years. Our results show that an elevated risk of acute gastrointestinal illness associated with child care is confined to children less than 3 years of age who regularly attend centers/nursery schools (odds ratio = 3.49, 95% confidence interval 0.99-4.77), controlling for other confounding variables. For children aged 3-5 years, low socioeconomic status, poverty, and seasonality are stronger predictors of acute gastrointestinal illness than is center care. Family day care appears to be unrelated to the risk of illness for both age groups.