Unintentional Injury in Early Childhood: Its Relationship with Childcare Setting

Introduction: Unintentional injury is the leading cause of death in children older than one year. A prevention framework that identifies the mechanisms through which social context, social position, and various exposures interact in the determination of health inequalities could reduce injury incidence. Aims: It is hypothesized that children aged 1 to 5 years who are cared for more than 10 hours per week by non-relatives or in locations outside of the home are at increased odds of injury compared to children who receive care from their parents at home. Methods: Data were obtained from the National Survey of Children's Health, 2007. Age, gender, race/ethnicity, and measures of poverty, family structure, parent education, and childcare location were compared with injury in the last 12 months. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained with SAS version 9.2. Results/Discussion: After adjustment, we found that children cared for by a non-relative in a childcare center were at increased odds of injury (OR: 1.30; 95% CI: 1.01,1.66) compared to children cared for their parents at home, as were males (OR: 1.42; 95% CI: 1.17,1.72) compared to females, and children whose mother's marital status was single, with no father present (OR: 1.53; 95% CI: 1.15,2.04) compared to two-parent biological or adopted couples. We also identified that injury in African American and Hispanic children was less prevalent than in Caucasians. Conclusions: The data suggest that children aged 1 to 5 years who are cared for by non-relatives in childcare centers are at increased odds of injury.