Does childcare influence socio-economic inequalities in unintentional injury? Findings from the UK Millennium Cohort Study
- 1 UCL Institute of Child Health, United Kingdom;
- 2 York and Humberside Public Health Observatory, United Kingdom;
- 3 University of York, United Kingdom
- Correspondence to: Anna Pearce, UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom; a.pearce{at}ich.ucl.ac.uk
- Received 6 May 2009
- Accepted 24 August 2009
- Published Online First 24 November 2009
Abstract
Background: In recent decades the proportion of infants and young children being cared for in childcare has increased. Little is known about the impact that non-parental care has on childhood unintentional injury and whether this varies by socio-economic group.
Methods: Using data from a contemporary UK cohort of children at age 9 months (N=18,114) and 3 years (N=13,718), we used Poisson regression to explore the association between childcare type (parental, informal, formal) and the risk of unintentional injury, overall and by socio-economic group.
Results: At age 9 months there was no overall association between childcare and injury. However, when stratifying the analyses, infants from higher socio-economic groups were less likely to be injured if they were cared for in formal childcare (compared to being cared for only by a parent), whereas those from lower social groups were more likely to be injured. At age 3 years informal childcare was associated with an increased risk of injury overall; in the stratified analyses this increased risk occurred only in less affluent groups. Formal childcare was no longer associated with injury at age 3 in any strata.
Conclusions: Previous findings have shown that childcare can have a positive influence on childhood injury; however, a recent UNICEF report highlighted that a lack of access to high quality childcare could lead to a widening of inequalities. Our analyses indicate that childcare does have the potential to widen inequalities in injury; further research is required to understand why childcare has a differential impact on unintentional injury and how this might be prevented.
