Accidents will happen? Unintentional childhood injuries and the effects of child care regulations.

Accidents are the leading cause of death and injury among children in the United States, far surpassing diseases as a health threat. We examine the effects of child care regulation on rates of accidental injury using both micro data from the National Longitudinal Survey of Youth, and Vital Statistics mortality records. Estimates from both data sources suggest that requiring day care center directors to have more education reduces the incidence of unintentional injuries. An auxiliary analysis of the choice of child care mode confirms that these regulations are binding and that higher educational requirements tend to crowd some children out of care, as do regulations requiring frequent inspections of child care facilities and lower pupil-teacher ratios. Thus, regulation creates winners and losers: Some children benefit from safer environments, while those who are squeezed out of the regulated sector are placed at higher risk of injury.