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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Lifetime risk of child protection system involvement in South Australia for Aboriginal and non-Aboriginal children,
Leonie Segal1, Ha Nguyen1, Mahayaudin M Mansor1
1Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Insights
Lifetime child protection system involvement is significantly higher for Aboriginal children than non-Aboriginal children, with increased early-life contact. This highlights disparities in child maltreatment experiences and system engagement.
Area of Science:
- Public Health
- Child Welfare
- Epidemiology
Background:
- Child protection services (CPS) aim to mitigate child maltreatment harms.
- Annual data on CPS involvement offers limited insight into lifetime exposure.
- A knowledge gap exists regarding the cumulative incidence of child protection involvement over a child's life.
Purpose of the Study:
- To delineate the lifetime involvement with child protection services (CPS) by contact type.
- To analyze cumulative incidence of CPS involvement from birth to age 18.
- To examine disparities in CPS involvement based on Aboriginal status.
Main Methods:
- Retrospective cohort study utilizing linked administrative data from South Australia (1986-2017).
- Inclusion of all children born in SA during the study period (N=608,547).
- Categorization of CPS involvement into notifications, investigations, substantiations, and out-of-home care (OOHC), analyzed by birth cohorts.
Main Results:
- Lifetime substantiated maltreatment affected 19-25% of Aboriginal children versus 3.2-3.6% of non-Aboriginal children.
- CPS involvement, particularly substantiations, occurred earlier in life for subsequent birth cohorts.
- Approximately 12.7% of Aboriginal children and 1.5% of non-Aboriginal children experienced out-of-home care.
Conclusions:
- Linked data provides crucial insights into life course CPS involvement and trends beyond annual data.
- Findings are vital for accurate burden of disease estimations and policy development.
- Monitoring CPS performance requires understanding lifetime involvement patterns.
Background:
Child protection services exist to reduce potential harms from child maltreatment. Many jurisdictions produce annual data on child protection system (CPS) involvement, leaving a gap in knowledge of lifetime involvement.
Objective:
To describe lifetime involvement in CPS, by type of contact.
Participants:
All 608,547 children born in South Australia (SA), Australia between 1986 and 2017.
Methods:
A retrospective cohort design using linked administrative data to report cumulative incidence of CPS involvement from birth to age <18 (or June30 2017) by Aboriginal status. CPS involvement was categorised into notifications (3 levels), investigations, substantiations and out-of-home care (OOHC). Cumulative incidence curves were derived for 5 birth cohorts.
Results:
Across childhood (to age <18 years), substantiated maltreatment was experienced by 3.2-3.6% of non-Aboriginal and 19-25% of Aboriginal children, 7 times reported annual substantiation rates. For most CPS categories CPS involvement increased until 2010, and was occurring earlier in life. By age 3, 0.5% of non-Aboriginal and 4.5% of Aboriginal children born 1986-1991 were the subject of a substantiation compared with 1.9% and 15% of non-Aboriginal and Aboriginal children, respectively, born 2010-2017. Incidence rates beyond age 3 were similar. OOHC contact was similar across cohorts, with ˜1.5% of non-Aboriginal and 12.7% of Aboriginal children ever-placed in care.
Conclusions:
Data linkage is an essential tool for understanding life course involvement with the CPS and describing trends not observable from annual snapshots. Such information is critical for burden of disease estimates, informing policy and monitoring CPS performance.
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