Effective Systems

Fatalities and the Organization of Child Care in the United States, 1985-2003


Using a comprehensive database of child care fatalities they created, Julia Wrigley and Joanna Dreby of the City University of New York Graduate Center found that child care fatalities are rarer than child fatalities outside of paid care. 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.  This study appears in the October 2005 issue of the American Sociological Review.

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. The stress of infant crying, in particular, can drive caregivers to impulsive acts of violence. 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.