Provider-reported illness and absence due to illness among children attending child-care homes and centers in San Diego, Calif

Purpose: To compare the incidence of provider-reported illness and absence due to illness among children attending small child-care homes, large child -care homes, and child care centers in a large metropolitan area. Methods: From July 6, 1992, through January 28, 1994, we collected informat ion from child-care providers on illness and absence due to illness at 64 s mall and 58 large child-care homes and 41 child-care centers. This included 113 446 child-weeks of information on 5360 children. Results: Providers reported 14 474 illness episodes (6.6 episodes per child -year) and 8593 days of absence due to illness (3.9 days per child-year). T he incidence of illness episodes was greatest in children who were younger than 1 year, white, or enrolled in small child-care homes. The incidence of absence due to illness was greatest in children who were 1 year of age, Hi spanic, or enrolled in child-care centers. Respiratory symptoms were most c ommonly associated with illness episodes and absence due to illness. Conclusions: Children in child-care homes had a greater incidence of provid er-reported illness than did those in centers. This risk varied by the type of facility and was greatest in small child-care homes. The increased risk for absence due to illness among children in child-care centers reflects e xclusion and attendance patterns. It may be possible to reduce the incidenc e of absence due to illness and subsequent economic impact of child-care-as sociated illness by educating providers on exclusion guidelines.