Impact of being taken into out-of-home care: a longitudinal cohort study of First Nations and other child welfare agencies in Manitoba, Canada

作者：Marni Brownell, Nathan Nickel, Kayla Frank, Lisa Flaten, Scott E. Sinclair, Stephanie Sinclair, Nora Murdock, Jennifer Enns, Jamie Pfau, Anita Durksen, Colette Scatliff, Heather J. Prior, Randy Walld, Lorna Turnbull, Karine Levasseur, Teresa Mayer, Jennifer Chartrand, Chris Nash, Elizabeth Decaire, Hygiea Casiano, Marlyn Bennett, Hera J M Casidsid, Mikayla Hunter, Hannah Owczar, Emily Brownell, Thérèse A. Stukel · 发表于：The Lancet Regional Health - Americas · 年份：2024 · DOI：10.1016/j.lana.2024.100886 · 被引用次数：4 · 研究领域：Child Abuse and Trauma、Child Welfare and Adoption、Homelessness and Social Issues

Background: Across Canada, Child Protection Services (CPS) disrupt Indigenous families by apprehending their children at alarmingly high rates. The harms borne by children in out-of-home care (OoHC) have been extensively documented. We examined the impact of OoHC on Manitoba children's health and legal system outcomes to provide rigorous evidence on how discretionary decision-making by CPS agencies can affect these outcomes. Methods: In partnership with First Nations researchers, we used linked administrative data to identify Manitoba children (born 2007-2018) served by First Nations and other Manitoba CPS agencies. We compared those taken into OoHC (n = 19,324) with those never in care but with an open CPS file due to child protection concerns (n = 27,290). We used instrumental variable analysis (CPS agency rates of OoHC as the instrument) to obtain odds ratios (aOR) and 95% confidence intervals adjusted for child, maternal, and family factors. Findings: Mean age (yrs ± standard deviation) at first CPS contact for children taken into OoHC was 2.8 ± 3.7 (First Nations) and 3.0 ± 3.8 (other), and for children never in care was 4.5 ± 4.5 (First Nations) and 5.1 ± 4.7 (other). Among children served by a First Nations agency, males made up 50.6% (n = 5496) in OoHC and 51.0% (n = 6579) never in care. Among children served by other agencies, males made up 51.0% (n = 4324) in OoHC and 51.0% (n = 7428) never in care. Odds of teen pregnancy (First Nations aOR 3.69, 1.40-9.77; other aO...