279
Camp Health Services
a great deal of anxiety for their family members. Unlike
at day care centers, once campers are at camp, their
health and safety are relatively unregulated. As early as
1966, studies reported a lack of research and govern-
mental interest in the medical care of children at summer
camp.
12
As reported by the CDC and GAO, this lack of
care is still the case.
5
The Recreational Camp Safety Act,
federal legislation that would monitor accident and ill-
ness in camp, has not proceeded far in Congress.
13
The
American Academy of Pediatrics provides guidelines for
screening and camp health, but these are purposefully left
quite general.
14,15
Most prior research has centered on the
epidemiology of illness and injury at individual camps
1622
or on the epidemiology of homesickness.
2327
This survey
was an initial attempt to identify some of the issues related
to how health care is provided at camp. The issues raised
may help guide further research and policy efforts.
The limitations of this study must be noted. First of
all, response was limited to 50% of the licensed camps.
However, the camps that responded did not differ sig-
nificantly in the variables of rental status and winterized
status from those that did not respond, suggesting sim-
ilarity between the 2 groups and reducing concern about
sampling bias. Another concern is generalizability. Only
Michigan camps were surveyed. However, given that
Michigan is among the best states in the nation in su-
pervising their camps, it is possible that the results rep-
resent a best-case scenario of what is present throughout
the rest of the country. In addition, response and trans-
port times are perceptual and may not reflect actual time.
Finally, although we know about CHOs and their limi-
tations, camper risk while at camp is unknown. Without
data that demonstrate the underlying risk rates for a large
population of campers, the effectiveness of any inter-
vention made in camp health remains unclear.
This survey reveals many opportunities for study in
this area. Further evaluation needs to be performed on a
multistate level to confirm the generalizability of these
findings. The epidemiology of injury and illness at sum-
mer camps requires further attention either at the state
or national level.
Those who agree to provide medical care for a camp
should look closely at the local medical environment and
ask questions of the camp director, the local EMS pro-
viders, and the urgent care facility or emergency de-
partment. Local EMS and emergency departments
should also reach out to camps and prepare for the influx
of campers that occurs each summer. Not all risk can be
eliminated, but with adequate planning, it can be mini-
mized.
Research has shown that camp is a wonderful expe-
rience for campers.
3,4
These results should encourage all
involved with camping to strive to make a great expe-
rience even better.
References
1. American Camping Association. The history of organized
camping. Available at: http://www.acacamps.org/media/
history.htm. Accessed September 3, 2002.
2. American Camping Association. Enriching lives, changing
the world. Available at: http://www.acacamps.org/aboutaca.
htm. Accessed September 3, 2002.
3. Thurber CA, Malinowski JC. The Summer Camp Hand-
book. Los Angeles, CA: Perspective Publishing; 2000.
4. American Camping Association. Marsh PE. What does
camp do for kids? Available at: http://www.acacamps.org/
research/marsh/index.htm. Accessed September 10, 2002.
5. Youth Camps: Nationwide and State Data on Safety and
Health Lacking: Report to U.S. House of Representatives,
Committee on Education and Labor, Subcommittee on
Health and Safety, 100th Cong, GAO/HRD-89140 (Sep-
tember 20, 1989).
6. American Camping Association. Standards at a glance.
Available at: http://www.acacamps.org/parents/accreditation/
stdsglance.htm. Accessed September 12, 2002.
7. Audi T, Montemurri P. Camp offenses spoil fun. Detroit
Free Press. April 16, 2001:sect A:1.
8. State of Michigan, Licensing Rules for Children's and
Adult Foster Care Camps, Act 116, Act 118, R400.11119
R400.11131 (2001).
9. National Highway Traffic Safety Administration. National
standard curricula. Available at: http://www.nhtsa.dot.gov/
people/injury/ems/nsc.htm. Accessed January 12, 2003.
10. Michigan Center for Rural Health. Michigan's small and
rural hospitals. Available at: http://www.com.msu.edu/
micrh/hosplist.htm. Accessed October 16, 2001.
11. American Heart Association. PALS Provider Manual. Dal-
las, TX: The Association; 2002.
12. Stanilonis PB, Meyer RJ. Health and safety in summer
camps. Public Health Rep. 1966;81:305310.
13. Recreational Camp Safety Act, HR 2451, 107th Cong
(2001).
14. Policy statement: health appraisal guidelines for day
camps and resident camps (RE9843). Pediatrics. 2000;
105:643644.
15. Policy statement: medical guidelines for day camps and
residential camps. Pediatrics. 1991;87:117119.
16. Trachtman H, Woloski-Wruble AC, Kilimnick N, et al. Pe-
diatric practice in a summer sleep-away camp. Clin Pe-
diatr (Philadelphia). 1994;33:649653.
17. Fiedelman W, Carbon K, Lewis D. Medical problems at a
summer camp. N Y State J Med. 1983;83:209212.
18. Schiff GM. Coxsackievirus B epidemic at a boys' camp.
Am J Dis Child. 1979;133:782785.
19. Meyer RJ, Kibrick AK, Kibrick S, Ryan MP, Godbout R,
Brown E. Epidemiology of summer camp accidents. Arch
Environ Health. 1963;7:6974.
