Child care is quite safe overall, and child care fatalities are rarer than outside of paid care, according to sociologists Julia Wrigley and Joanna Dreby, City University of New York Graduate Center, who created a comprehensive database of child care failures, including fatalities, between 1985 and 2003. But they found that the fatality rate for children who receive child care in private homes is sixteen times higher than the fatality rate for children in child care centers. The study appears in the October issue of the American Sociological Review, published by the American Sociological Association.
While more than 8 million children are in paid child care every day, until now little has been known about their safety. Wrigley and Dreby analyzed reports of 1,362 fatalities (among 4,356 caregiving failures) from 1985 to 2003. The fatality data was gathered from media reports, legal cases, and state records. Three forms of child care were investigated: child care centers, nannies working in children's homes, and family day care providers working in their own homes.
"While accidents can happen anywhere, child care centers are almost 100% protective against children's deaths by violence. They are much safer than arrangements in private homes," explains Wrigley.
Infants are by far the most vulnerable children in care. Their fatality rate from both accidents and violence is nearly seven times higher than that of children from one to four. Equally striking are differences in infant fatality rates across types of care. The infant fatality rate in the care of nannies or family day care providers is more than seven times higher than that in centers.
Why are centers the safest form of child care?
Wrigley and Dreby conclude that centers are the safest form of child care because they afford children multiple forms of protection. Most importantly, staff members do not work alone. They have others watching them and helping them cope with fussy infants or whining toddlers. This helps them maintain their emotional control. It also helps identify and remove unstable or volatile workers. Center teachers also have more training than most caregivers in private homes and they are supervised by professionally-trained directors. Finally, centers control access by outsiders more effectively to keep out people who might pose risks.
These protections help reduce risks of accidental deaths, such as suffocation and drowning. But they are especially important in preventing violent deaths. Not a single shaken baby fatality was found in a child care center, while 203 were reported in arrangements in private homes. With little professional training, without supervisors or coworkers, and often paid very little for long hours of work, even some experienced caregivers can lose emotional control. Once children are past the toddler years, safety differences between centers and other forms of child care diminish.
Wrigley says, "Child care is quite safe overall, but it could be made safer. We need to recognize what a stressful and demanding job it is to look after young children. Improved safety will only come with more resources and closer regulation of care."
How can child care safety be improved?
- Recognize the safety advantages of centers and provide funding for the expansion of center care for the most vulnerable children, infants.
- Offer more training and support for caregivers working in private homes.
- Expand the resources for licensing and regulation so that "bad apples" in child care can be identified and excluded from the field.
- Collect safety data so that parents can choose care arrangements wisely and prevention strategies can be developed with full information.
