Rl. Cordell et al., Provider-reported illness and absence due to illness among children attending child-care homes and centers in San Diego, Calif, ARCH PED AD, 153(3), 1999, pp. 275-280
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.