Entering out-of-home care during childhood: Cumulative incidence study in Canada and Australia

Abstract

Cumulative incidence provides a more accurate indicator than annual incidence rates of the number of children who experience out-of-home care during childhood. The study utilises a cohort of all children born in Western Australia (WA) 1994-2005 and Manitoba 1998-2008 using de-identified linked data. Life tables were used to calculate the age-specific cumulative incidence over time and for at-risk groups. Cox regression was used to compare risk factors for entry to care. Manitoba had a larger proportion of children entering care compared to WA (9.4% vs 1.5% by age 12). Over time children entered care at a younger age in both WA (HR=1.5, CI:1.4-1.5) and Manitoba (HR=1.5, CI:1.5-1.6). Similar factors were associated with earlier age care entries in both countries including: socioeconomic disadvantage, young maternal age, maternal hospital admissions for mental health issues, substance misuse and assault. Supplementary analysis for WA showed a time trend with young children (<3years of age) who entered care spending an increasing proportion of their early years in care. Whilst Manitoba had a larger proportion of children entering care, over time in Western Australia children have been entering care at a younger age and spending more time in care. These latter factors contribute to an increased burden on the out-of-home care system. Manitoba had over five times greater cumulative incidence than WA, however risk factors for entry to out-of-home care were consistent in both countries. Knowledge of the risk factors for entry to out-of-home care can inform targeted support and prevention programs.

Changes in out of home care and permanence planning among young children in Scotland, 2003 to 2017

“…Over the same period, the proportion of young children on CSOs who resided with their parent(s) at any point and at three years of age has decreased significantly. Similar trends of early removal from parents and increased use of out of home placements have been observed in some other countries (Gilbert, 2012), including England (McGrath-Lone et al, 2016Ubbesen et al, 2015), Australia and Canada (Marsh et al, 2017;O'Donnell et al, 2016). We found that at both time periods, most children who were removed from parental care had not been returned by the age of three years, and that the proportion who remained away from parents increased between cohorts.…”

Medical diagnoses among infants at entry in out‐of‐home care: A Swedish population‐register study

“…A maternal socioeconomic risk profile was evident for infants in the “Problems Related to Social Environment/Upbringing” sample, as previously reported for out‐of‐home care . This pattern was, however, less pronounced for infants associated with SBS/AHT criteria, who, surprisingly, had parents who scored better for education, living together, and smoking.…”

“…The overall incidence of all infants with first entry into out‐of‐home care, although increasing during the study period, was comparable with that in Western Australia 1994 to 2005, slightly lower than that in England 1995 to 2008, and higher than that in Denmark, where the incidence has been declining …”

“…36 This is the first Swedish study addressing medical diagnoses and A maternal socioeconomic risk profile was evident for infants in the "Problems Related to Social Environment/Upbringing" sample, as previously reported for out-of-home care. 7,35,37 This pattern was, however, less pronounced for infants associated with SBS/AHT criteria, who, surprisingly, had parents who scored better for education, living together, and smoking. Biological risk factors such as smoking, 38 SGA, 39 obesity, 40 and prematurity 39 are known to be more prevalent among socioeconomically disadvantaged individuals, and socioeconomic factors are also associated with child morbidity 41 and child mortality.…”

At Cross roads: White Social Work in Australia and the discourse on Australian multiculturalism

“…The apology remains deficient when we closely look at social work intervention and public policy in the area of removal of Indigenous children. For instance a most recent study from Western Australia has revealed that Indigenous children were 'eight times' more likely to enter out-of-home care than non-Indigenous children (O'Donnell et al, 2016). In addition, Australia has highlighted Indigenous over-representation in the National Child Protection Framework, 2009-2020 with a view to reduce child protection intervention.…”