| Literature DB >> 28208690 |
Rachael Lefebvre1, Barbara Fallon2, Melissa Van Wert3, Joanne Filippelli4.
Abstract
There is strong evidence that poverty and economic disadvantage are associated with child maltreatment; however, research in this area is underdeveloped in Canada. The purpose of this paper is to examine the relationship between economic hardship and maltreatment for families and children identified to the Ontario child protection system for a maltreatment concern. Secondary analyses of the Ontario Incidence Study of Reported Child Abuse and Neglect-2013 (OIS-2013) were conducted. The OIS-2013 examines the incidence of reported maltreatment and the characteristics of children and families investigated by child welfare authorities in Ontario in 2013. Descriptive and bivariate chi-square analyses were conducted in addition to a logistic regression predicting the substantiation of maltreatment. In 9% of investigations, the household had run out of money for food, housing, and/or utilities in the past 6 months. Children in these households were more likely to have developmental concerns, academic difficulties, and caregivers with mental health concerns and substance use issues. Controlling for key clinical and case characteristics, children living in families facing economic hardship were almost 2 times more likely to be involved in a substantiated maltreatment investigation (OR = 1.91, p < 0.001). The implications in regard to future research and promoting resilience are discussed.Entities:
Keywords: child maltreatment; developmental outcomes; economic hardship; resilience
Year: 2017 PMID: 28208690 PMCID: PMC5371750 DOI: 10.3390/bs7010006
Source DB: PubMed Journal: Behav Sci (Basel) ISSN: 2076-328X
Variables used in the present analyses.
| Variable | Definition |
|---|---|
| Child Age | Workers were asked to indicate the age of the investigated child. |
| Child Ethno-racial Group | Workers were asked to indicate the ethno-racial background that best described the investigated child. |
| Child Functioning Concerns | Workers were asked to identify the child’s level of functioning for 18 concerns. For each functioning concern, response options were confirmed, suspected, no, or unknown. Confirmed and suspected responses were collapsed into ‘noted’, and no and unknown response options were collapsed into ‘not noted’. The following child functioning concerns were examined as part of this analysis: internalizing behaviors, externalizing behaviors, developmental concerns, and academic difficulties. Workers could note multiple child functioning concerns. Internalizing behaviors was derived by collapsing the following concerns: depression/anxiety/withdrawal, suicidal thoughts, self-harming behavior, and attachment issues. Externalizing behaviors was derived by collapsing the following concerns: ADD/ADHD, aggression, running from home, and Youth Criminal Justice Act involvement. Developmental concerns were derived by collapsing the following concerns: intellectual/developmental disability, failure to meet developmental milestones, and FAS/FAE (fetal alcohol syndrome/fetal alcohol effects). |
| Previous Substantiated Investigation | Workers were asked to indicate whether the investigated child had any alleged maltreatment against them substantiated prior to the current investigation. |
| Primary Caregiver Age | Workers were asked to indicate the age of the primary caregiver. |
| Primary Caregiver Risk Factors | Workers were asked to identify risk factors for the primary caregiver. For each risk factor, response options were confirmed, suspected, no, or unknown. Confirmed and suspected responses were collapsed into ‘noted’ and no and unknown response options were collapsed into ‘not noted’. This analysis examined the following caregiver risk factors: alcohol abuse, drug/solvent abuse, cognitive impairment, mental health issues, physical health issues, few social supports, and history of foster care or group home. Workers could note multiple risk factors. Two categories were derived for the purpose of this analysis: (i) alcohol abuse and drug/solvent abuse were collapsed for the bivariate and multivariate analyses; (ii) mental health issues and physical health issues were collapsed for the multivariate analyses. |
| Case Previously Opened | Workers were asked to indicate if the family had a case opened for child welfare services in the past, and could note that the case had never been previously opened, opened once before, opened two or three times before, opened more than three times before, or that they did not know. |
| Household Ran Out of Money for Food, Housing and/or Utilities | Workers were asked to indicate if the household had run out of money for food, housing, and/or utilities in the last six months. From these variables, we derived our composite measure of economic hardship by noting whether a household was noted by the worker as experiencing any one of these conditions. |
| Primary Maltreatment Category | Workers could identify up to three forms of investigated maltreatment from a list of 32 codes. For the primary maltreatment, workers were asked to indicate the maltreatment code that best characterized the investigation. These 32 codes were collapsed into five major maltreatment types: physical abuse (i.e. shake, push, grab, or throw; hit with hand; punch, kick or bite; hit with object; choking; poisoning; stabbing; or other physical abuse), sexual abuse (i.e. penetration; attempted penetration; oral sex; fondling; sex talk or images; voyeurism; exhibitionism; exploitation; or other sexual abuse), neglect (i.e. failure to supervise: physical harm; failure to supervise: sexual abuse; permitting criminal behavior; physical neglect; medical neglect; failure to provide psychological treatment; abandonment; or educational neglect), emotional maltreatment (i.e. terrorizing or threat of violence; verbal abuse or belittling; isolation/confinement; inadequate nurturing or affection; or exploiting or corrupting behavior), and exposure to intimate partner violence (IPV) (i.e. direct witness to physical violence; indirect exposure to physical violence; exposure to emotional violence; or exposure to non-partner physical violence). For more information on the definitions given to workers for each of the 32 forms of maltreatment, please see the OIS-2013 Guidebook in Fallon et al. (2015) [ |
| Maltreatment Substantiation | For each form of maltreatment, workers were asked to indicate, based on their clinical judgment, the substantiation level for the investigation: unfounded (balance of evidence implied that the maltreatment did not occur); suspected (that there was not enough evidence to confirm that maltreatment had occurred, but maltreatment could not be ruled out); or substantiated (balance of evidence implied that the maltreatment occurred). Bivariate chi-square analyses were conducted to examine the similarity between suspected and substantiated cases. Since case characteristics of suspected cases were not significantly different from substantiated cases, we collapsed suspected and substantiated investigations for the logistic regression analysis. |
| Duration of Maltreatment | Workers were asked to indicate the duration of substantiated maltreatment as either a single incident or multiple incidents. |
| Household Income | Workers were asked to identify the primary source of income for up to two caregivers in the household. From these responses, a household income measure was derived. |
| Housing | Workers were asked to indicate the housing category that best described the living situation of the household at the time of the referral for investigation. |
| Home overcrowding | Workers were asked to indicate whether they felt, in their clinical opinion, that the household was overcrowded. |
| Unsafe housing | Workers were asked to identify if there were unsafe housing conditions (e.g., mold, inadequate heating, fire/electrical hazards). |
| Mental or emotional harm | When maltreatment was substantiated or suspected, the worker was asked to indicate whether the child was showing signs of mental or emotional harm. |
| Physical harm | Workers were asked to indicate if there was physical harm to the child. |
Percentage of socio-economic risk factors for all maltreatment-related investigations.
| Socio-Economic Variables | # | % |
|---|---|---|
| Income | ||
| Full-time | 54,544 | 63 |
| Part-time/seasonal | 7776 | 9 |
| Social assistance/benefits | 22,663 | 26 |
| None | 1644 | 2 |
| Housing type | ||
| Own home | 39,013 | 45 |
| Rental | 33,989 | 39 |
| Public or band housing | 8427 | 10 |
| Temporary arrangement/other | 5197 | 6 |
| Home overcrowded | 6453 | 7 |
| Unsafe housing | 3949 | 5 |
Note: This bolded variable is the variable used for our bivariate and multivariate analyses to follow.
Bivariate analyses for all maltreatment-related investigations.
| Case Characteristics | Household Ran Out of Money | ||||
|---|---|---|---|---|---|
| Yes | No | ||||
| # | % | # | % | x2 | |
| Primary caregiver risk factors | |||||
| Alcohol/substance abuse | 3107 | 40 | 8292 | 11 | 139.071 *** |
| Cognitive impairment | 976 | 13 | 2535 | 3 | 67.288 *** |
| Mental health issues | 3469 | 45 | 14,287 | 18 | 131.737 *** |
| Physical health issues | 1244 | 16 | 4148 | 5 | 59.143 *** |
| Few social supports | 3860 | 50 | 16,247 | 21 | 143.245 *** |
| History of foster care/group home | 1188 | 15 | 2843 | 4 | 93.514 *** |
| Case history | |||||
| No previous investigation | 1591 | 21 | 29,693 | 38 | 53.793 *** |
| One previous investigation | 1118 | 14 | 14,348 | 18 | |
| Two + previous investigations | 5002 | 65 | 34,876 | 44 | |
| Child functioning | |||||
| Internalizing issues | 2335 | 30 | 22,284 | 28 | 1.219 |
| Externalizing issues | 2398 | 31 | 20,464 | 26 | 3.057 |
| Developmental concerns | 1902 | 25 | 13,478 | 17 | 15.512 *** |
| Academic difficulties | 1793 | 23 | 13,018 | 16 | 9.219 ** |
** p <0.01; *** p < 0.001.
Multiple logistic regression predicting substantiation of maltreatment in maltreatment investigations.
| Level | Variables Entering Model | Odds Ratio | 95% Confidence Interval | ||||
|---|---|---|---|---|---|---|---|
| 1 | Child age | 0.02 | 0.01 | 0.093 | 1.02 | 0.99 | 1.04 |
| Child ethnicity (white as reference) | |||||||
| Black | 0.37 | 0.16 | 0.027 | 1.44 | 1.04 | 1.99 | |
| Aboriginal | 0.04 | 0.14 | 0.761 | 1.05 | 0.79 | 1.39 | |
| Other | 0.14 | 0.12 | 0.265 | 1.15 | 0.90 | 1.46 | |
| 2 | Young caregiver (over 30 years as reference) | ||||||
| 21 and under | 0.01 | 0.25 | 0.985 | 1.01 | 0.62 | 1.64 | |
| 22–30 | −0.05 | 0.12 | 0.653 | 0.95 | 0.76 | 1.19 | |
| Caregiver substance abuse | 0.69 | 0.15 | 0.000 | 1.99 | 1.50 | 2.66 | |
| Caregiver mental/physical health concern | 0.55 | 0.10 | 0.000 | 1.74 | 1.42 | 2.13 | |
| 3 | Primary maltreatment type (physical abuse as reference) | ||||||
| Sexual abuse | −0.08 | 0.25 | 0.727 | 0.92 | 0.57 | 1.49 | |
| Neglect | 0.26 | 0.12 | 0.033 | 1.29 | 1.02 | 1.63 | |
| Emotional maltreatment | 1.23 | 0.15 | 0.000 | 3.43 | 2.56 | 4.59 | |
| Exposure to IPV | 2.00 | 0.12 | 0.000 | 7.39 | 5.85 | 9.32 | |
| Previous substantiated maltreatment | 0.66 | 0.09 | 0.000 | 1.98 | 1.65 | 2.38 | |
| 4 | Household income (full time as reference) | ||||||
| Part-time/seasonal | 0.032 | 0.154 | 0.836 | 1.032 | 0.764 | 1.395 | |
| Social assistance/benefits | −0.126 | 0.113 | 0.266 | 0.882 | 0.707 | 1.101 | |
| None | 0.20 | 0.32 | 0.531 | 1.22 | 0.66 | 2.26 | |
| Housing type (own home as reference) | |||||||
| Rental | −0.04 | 0.10 | 0.681 | 0.96 | 0.78 | 1.18 | |
| Public or band housing | −0.22 | 0.16 | 0.180 | 0.81 | 0.59 | 1.11 | |
| Temporary arrangement/other | 0.32 | 0.22 | 0.141 | 1.38 | 0.90 | 2.13 | |
| Home overcrowding | 0.49 | 0.18 | 0.007 | 1.62 | 1.14 | 2.31 | |
| Unsafe housing conditions | 1.30 | 0.23 | 0.000 | 3.63 | 2.32 | 5.70 | |
| Household ran out of money | 0.65 | 0.17 | 0.000 | 1.91 | 1.38 | 2.64 | |
Bivariate analyses for all substantiated maltreatment investigations.
| Characteristics of Maltreatment | Household Ran Out of Money | ||||
|---|---|---|---|---|---|
| Yes | No | ||||
| # | % | # | % | x2 | |
| Primary maltreatment type | 47.051 *** | ||||
| Physical abuse | 212 | 5 | 3359 | 13 | |
| Sexual abuse | - | - | 432 | 2 | |
| Neglect | 1716 | 43 | 5367 | 21 | |
| Emotional maltreatment | 273 | 7 | 4020 | 15 | |
| Exposure to IPV | 1791 | 45 | 12,812 | 49 | |
| Duration | 2.274 | ||||
| Single incident | 1414 | 36 | 10,772 | 41 | |
| Multiple incidents | 2568 | 64 | 15,216 | 59 | |
| Mental or emotional harm | 1206 | 30 | 9498 | 37 | 2.606 |
| Physical harm | 110 | 3 | 1448 | 6 | 2.037 |
|
| |||||
*** p < 0.001.
Bivariate analysis for subtypes of substantiated neglect
| Subtypes of Neglect | Household Ran Out of Money | ||||
|---|---|---|---|---|---|
| Yes | No | ||||
| # | % | # | % | x2 | |
| Types of neglect | 37.519 *** | ||||
| Failure to supervise | 605 | 35% | 3148 | 59% | |
| Permitting criminal behaviour | - | - | - | - | |
| Physical neglect | 730 | 43% | 774 | 14% | |
| Medical neglect | 202 | 12% | 239 | 4% | |
| Failure to provide psych treatment | - | - | 237 | 4% | |
| Abandonment | - | - | 607 | 11% | |
| Educational neglect | 126 | 7% | 305 | 6% | |
*** p < 0.001.