Medical neglect in Ontario: Implications for health care provision

This study explores child welfare investigations for medical neglect in Ontario, Canada, focusing on household, family and child characteristics of such investigations and factors associated with substantiated victimization.

This analysis used data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018. Bivariate analyses compared medical neglect with other neglect investigations to create a profile of medical neglect investigations in Ontario, and a binary logistic regression determined which case characteristics were associated with substantiation of medical neglect.

Compared with other neglect investigations, medical neglect investigations were more likely to involve children less than 1 year old and caregivers under 21 years old, households that had run out of money in the past 6 months for basic necessities, primary caregivers with few social supports, mental health issues or drug/solvent abuse concerns, and children with at least one functioning concern. Medical neglect investigations in which the primary caregiver had few social supports were almost four times more likely to be substantiated (OR=3.698, P<0.05).

While the public's perception of medical neglect tends to focus on parental refusal of treatment due to philosophical/religious beliefs, this Ontario sample indicates that medical neglect is often driven by financial constraints and a lack of social support. Implications for health care providers within a universal health care system are discussed.