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Increased use of group child care has raised concern about the negative health consequences of such care, because the daily interaction of children promotes the spread of infectious disease. This Note, reprinted from The American Journal of Public Health, Sept. 1988, uses nationally representative data from the Child Health Supplement of the 1981 National Health Interview Survey to test the hypothesis that the larger the groups in which children receive care, the more days per year they spend in bed due to illness. The authors estimate a model of annual bed days for children 6 months to 2.5 years old and separately for children 2.5 to 5 years old. Their results show significantly higher numbers of bed days for children in day care centers than for children at home for both age groups, controlling for confounding factors. Children in family day care have significantly more bed days than those at home, but only among the younger sample. The negative effect of family day care is less than that of child care centers. Although the relative effect of group care is to increase annual bed days by 30 to 19 percent, the absolute effect is modest, with children in group care having 1.3 to 0.6 more bed days per year.

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