Health and Safety

Health

• Immunizations - Have dramatically reduced deaths from most major childhood diseases, such as polio, in industrialized countries. Many American parents choose to not fully immunize their children for a variety of reasons including the fear of autism, despite inconclusive scientific proof, This has led to a subsequent rise in contagious diseases such as pertussis (whooping cough) and measles. Most states have mandated vaccines for adults working in education.
• Infectious diseases - Responsible for most child deaths in developing countries. Children in poverty are most vulnerable to diseases since many are not immunized and lack adequate nutrition. Malnutrition depresses the immune system, rendering these children at even greater risk. The most common causes of death are diarrhea and pneumonia. Recent interventions, such as oral rehydration therapy and zinc supplements, have dramatically reduced deaths from dehydration due to diarrhea (Victoria, Bryce, Fonatiane, & Monasch, 2000).
• Otitis media (ear infection) - Occurs in the middle ear and is most common in children from six months to six years. Almost all young children (85%) will have otitis media by the time they are three years old. Among the factors that can increase risk are second-hand smoke and early low-quality childcare. Ear infections can interfere with hearing and delay children’s language development. This in turn can disrupt social-emotional and cognitive development. Untreated and repeated ear infections, common to low-SES children, can result in hearing loss.
• Myopia (nearsightedness) - The inability to see well at a distance because of an elongated eye shape. This easily corrected visual problem affects 60% of the U.S. population by adulthood. Myopia is usually diagnosed between the ages of five and ten and progresses until about age 20. The most common form of myopia is hereditary, but it is also influenced by experience. Research has shown that you can indeed “ruin your eyes” with eye strain (Goss & Rainey, 1998). This is the only health condition that increases (rather than decreases) with SES level.
• Nocturnal enuresis (nighttime bedwetting) - Affects about 10% of school-age children in North America, boys more often than girls. Wetting at night is common in early childhood, but by the time they are six years old, 90% of children are using the toilet completely. Nocturnal enuresis usually has a biological basis, and treatment should be sought as soon as possible to limit damage to the child’s self-esteem (Longstaffe, Moffatt, & Whalen, 2000).
• The COVID-19 pandemic has changed many of our approaches to health and safety, leading to more germ-awareness and hygienic practices.  The pandemic has also made programs reconsider groupings, air quality, and more to minimize the spread. 

Safety

There are myriad dangers in the world for young children; the type and extent of risks are largely determined by their environments. Some children are at particularly high risk because of their temperament, poverty, or high stress.

• Unintentional injuries - The leading cause of death in preschool-aged children in industrial countries. According to the Children’s Defense Fund, in 2003 accidents caused 40% of children’s deaths and 70% of adolescents. Car accidents are the most frequent cause of unintentional injury and deaths to children—in fact, victims of auto accidents are most often under 15 years of age. More than 80% of these car-related child deaths occurred when the children were not in the car but were either on foot or on bikes. Almost all of these deaths were attributable to back- or front-overs (Kidsandcars website, 2002-2007). While car seats will not prevent these types of deaths, their use dramatically reduces injuries and fatalities in traffic accidents.
• Common accidents - Most common accidents that injure preschoolers usually happen at home. These include falls, choking, drowning, burns, poisoning, and gun-inflicted injuries.
• Risks for injuries - Risks vary according to many factors, placing some preschoolers at higher risk than others. For example, injuries are more likely to happen to children who are boys, are temperamentally difficult, are impoverished, or live in crowded, inner-city, and/or stressful homes (Laing & Logan, 1999; Mathey, 1991; Ramsey, Moreton, Goreman, Blake, Goh, & Elton, 2003).
• Child abuse and neglect - please see the handout on signs