"The working mothers who live in New York City's housing projects lean gratefully on the women who keep their children.

...Now city officials estimate that 100 of these day care centers - many of them in public housing projects - violate state fire regulations that require each day care center to have at least two exits that are remote from each other. Many day care providers, some of whom have operated for decades, fear they may have to close their centers. They say the regulations are unfair, vaguely written, and have never been enforced."

(Source: Kareem Fahim, "Enforcement of Fire Codes Threatens Day Care Sites," The New York Times, May 22, 2005; http://www.nytimes.com/2005/05/22/nyregion/22daycare.html?th&emc=th .)

"'A day nursery...is no good for an infant.  There's nowhere near enough attention or affection to go around.'  Since children need full-time love and attention in their early years, [Spock] argued, it is senseless for parents to 'pay other people to do a poorer job of bringing up their children.'"

(Source:  Benjamin Spock, quoted in Brian C. Robertson, Day Care Deception, San Francisco: Encounter Books, 2003, page 72.)

Putting young children in day care means exposing them to health risks not faced by children cared for at home by their mothers. Placement in day care especially elevates the health risks for infants. The health hazards of day care come into mathematically precise focus in a study recently published by researchers from Johns Hopkins University, South Carolina University, and Western Kentucky University. 

The authors of the new study assess the health care risks of day care by analyzing data collected for 1188 children - some in day care, some cared for at home - enrolled for medical care either through a Health Maintenance Organization (HMO) or a consortium of Medicaid providers in Columbia, South Carolina. These data show that "in general, risks of diarrheal illness and U[pper]R[espiratory]I[nfection] in day-care children are greater than in home-care children." Indeed, when comparing day-care children to peers cared for at home, the researchers calculate statistically elevated risks for day-care children in contracting Mild Diarrhea (Odds Ratio of 1.83), Severe Diarrhea (Odds Ratio of 1.79), Mild Upper Respiratory Illness (Odds Ratio of 1.96), and Severe Upper Respiratory Illness (Odds Ratio of 1.64). 

The authors of the new study are not surprised by their findings, since they are "consistent with previous studies [showing] that day-care children are at a higher risk of contracting both diarrheal illness and U[pper]R[espiratory]I[llness] compared to home-care children."   The researchers do, however, note that the health risks associated with placement in day-care depend in part on the age of the children.  "Among day-care children," write the scholars, "the youngest group was at the highest risk of contracting both diarrhea and U[pper] R[espiratory]I[llness]."  The particular vulnerability of very young day-care children appears most pronounced for Upper Respiratory Illness.  Thus, when looking specifically at children less than eighteen months old, the researchers calculate that day-care children are nearly four times as likely to contract Mild Upper Respiratory Illness than home-care peers (Odds Ratio of 3.61) and are almost three times as likely to contract Severe Upper Respiratory Illness (Odds Ratio of 2.94).

In concluding their study, the research team comments on what might strike some as a decidedly unhealthy social pattern: "Despite persuasive evidence of higher risk of acquiring common infectious diseases in day care settings, the demand for child day care services is increasing."