Accidents will happen? Unintentional injury, maternal employment, and child care policy

In western countries, accidents are the leading cause of death and injury among children, far surpassing diseases as a health threat. We examine the effect of maternal employment and child care policy on rates of accidental injury using both micro data from the National Longitudinal Survey of Youth (NLSY) and Vital Statistics records. We find that the effects of maternal employment on unintentional injuries to children vary by demographic group, with the effects being positive for blacks and negative for whites in models that control for child-specific fixed effects. Estimates from both individual-level NLSY and Vital Statistics data suggest that the effects of maternal employment may be mediated by child care regulations. Most notably, requiring training beyond high school for caregivers reduces the incidence of both fatal and non-fatal accidents. Other types of regulation have mixed effects on unintentional injuries, suggesting that child care regulations create winners and losers. In particular, while some children may benefit from safer environments, others that appear to be squeezed out of the more expensive regulated sector and are placed at higher risks of injury.