San Diego Day Care Programs to Be Studied for U.S. Report

San Diego has been selected as one of two sites in the nation--and the only one in California--to study the health and safety of children in day care programs, officials announced Tuesday.

The federal Centers for Disease Control launched the three-year project in hopes of creating guidelines that would enable day care homes and centers to reduce the risk of injury and illness affecting the young.

“This is important because of the trend toward increased use in day care nationally that has been going on for decades,” said Dr. Stephan Waterman, chief of the County Health Services Department’s community disease control division. “Are there any health risks for children when you leave them in a day care setting? We need to answer that question.”

Some small-scale studies have suggested that children in day care suffer higher rates of diarrhea and respiratory ailments. With the CDC project here and in Seattle, federal officials hope to learn whether this is, indeed, true and whether there are solutions to curb those risks.

CDC officials also expect to ascertain the economic costs associated with having a sick child: How much money do parents spend on medical care? How much do they spend on additional child care when their child is too sick to attend his usual facility?

The CDC’s efforts are all part of an ongoing preventive medicine program for children launched by its director, Dr. William Roper.

“Every dollar spent for prevention saves $30 in treatment and care,” said CDC spokesman Bob Howard. “It is so easy to overlook prevention, particularly in tough times. But it is a whole lot easier to deal with an immunization bill than a hospital bill. This is all about preventing diseases and injury.”

San Diego County has almost 130,000 children who need or use licensed child care, said Waterman, principal investigator of the CDC study, citing a 1991 estimate by the San Diego Assn. of Governments. For parents here as well as across the nation, scrambling for safe child care is as much a part of parenthood as diapering.

In launching the project, which will be run with a $207,000 grant for the first year, health officials will study child care in three settings: small family care for up to six children run from a person’s home, larger home-run facilities licensed for up to 12 kids, and day care centers.

“It is a great idea. If you have done child care, you know you are going to get a certain number of illnesses or bumps and scrapes. Everybody wants to see their children safe and healthy, and that is part of the program’s goal,” said Cynthia Wright, who is participating in the study and runs a small program from her Mira Mesa home. “I am always looking for ways to improve the child care I am providing.”

County health department workers and four graduate students from San Diego State University will collect information on illnesses, injuries, and potential hazards in 200 local facilities on a weekly basis. They also will quiz staff on their knowledge, attitudes, beliefs, and practices.

In addition, a survey will be given to 400 parents and 180 child care providers, hoping to determine what concerns they have when contemplating the risks of child care programs, said Dr. Albert Chang, co-investigator of the CDC study here and head of San Diego State University’s division of maternal and child health.

In the survey, people will be asked questions that might include: What do you consider a safe child care setting? What might reduce the possibility of injuries and transmission of infectious diseases?

The participants from child care facilities, all randomly selected, volunteer to fill out daily logs, recording attendance, illness and injury. After the first year, officials will work with half the participants, providing education and training. They also will try to bring facilities into line with the suggested guidelines recently issued by the American Academy of Pediatrics and the American Public Health Assn.

The program, known as the San Diego Safe and Healthy Children in Child Care Project, “is something needed to better understand the risk factors so they can be modified and reduced in order to make child care a safe and healthy experience,” Chang said.

Today, Chang and his co-workers are seeking child care facilities to participate in the project.

When contacted, Lisa Hiew jumped at the opportunity. Hiew runs a day care program for up to 12 children from her Rancho Bernardo home. To her, it has always seemed as though the children attending her program got sick in batches, and sometimes it appeared to be influenced by factors like changes in the weather.

“I am sure every day care is different,” she said, “I just wish I could find out what happens at other day care centers.”