Understanding the overrepresentation of Black children in Ontario's child welfare system: Perspectives from child welfare workers and community service providers

Antwi-Boasiako, Kofi; Fallon, Barbara; King, Bryn; Trocmé, Nico; Fluke, John D.

doi:10.1016/j.chiabu.2021.105425

Cited by 9 publications

(4 citation statements)

References 37 publications

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“…The fear of causing harm was particularly salient in our sample and affirms what has previously been reported by resident and non-resident samples across the globe [ 30 , 37 , 68 , 69 ]. Some residents in our sample described this fear in relation to the possibility of contributing to the over-representation of Indigenous and racial and ethnic minority children in foster care, as well as those from families living in communities with high rates of poverty.…”

Section: Discussionsupporting

confidence: 89%

A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

Laupacis

Acai

MacMillan

et al. 2022

IJERPH

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Child maltreatment (CM) is a public health problem with devastating effects on individuals, families, and communities. Resident physicians have varied formal education in CM, and report feeling inadequately trained in identifying and responding to CM. The purpose of this study is to explore residents’ understanding of the impacts of CM, and their perceptions of their role in recognizing and responding to CM to better understand their educational needs. This study analyzed qualitative data obtained from a larger project on family violence education. Twenty-nine resident physicians enrolled in pediatric, family medicine, emergency medicine, obstetrics and gynecology, and psychiatry training programs in Alberta, Ontario, and Québec participated in semi-structured interviews to elicit their ideas, experiences, and educational needs relating to CM. Conventional (inductive) content analysis guided the development of codes and categories. Residents had thorough knowledge about the impacts of CM and their duty to recognize CM, but there was less consistency in how residents understood their role in responding to CM. Residents identified the need for more education about recognizing and responding to CM, and the need for educational content to be responsive to training, patient and family factors, and systemic issues. Despite knowledge about the impacts of CM and laws pertaining to mandated reporting, residents reported challenges with responding to concerns of CM. Findings of this study emphasize the need for better training in response to CM. Future educational interventions should consider a multidisciplinary, experiential approach.

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Section: Discussionsupporting

confidence: 89%

A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

Laupacis

Acai

MacMillan

et al. 2022

IJERPH

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“…Our study results were mixed with regards to the association of race and ethnicity and insurance status with reporting practices. Prior literature raises concerns of CPS reporting bias related to race and ethnicity and socioeconomic status . Institutions should standardize their approach to reporting to reduce implicit bias and ensure all families are treated equally regardless of perceived race and socioeconomic status …”

Section: Discussionmentioning

confidence: 99%

“…Prior literature raises concerns of CPS reporting bias related to race and ethnicity and socioeconomic status. [58][59][60][61][62][63][64] Institutions should standardize their approach to reporting to reduce implicit bias and ensure all families are treated equally regardless of perceived race and socioeconomic status. 65 Notably in 43.6% of the total medical encounters with positive illicit drugs tests, the child had previously been reported to CPS.…”

Section: Jama Network Open | Pediatricsmentioning

confidence: 99%

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Rebbe,

Malicki,

Siddiqi

et al. 2024

JAMA Netw Open

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ImportanceYoung children are ingesting illicit drugs at increased rates, but it is unknown what the associated child protection system (CPS) responses are when a child tests positive.ObjectiveTo document the child protection system involvement and the characteristics of children who test positive for illicit substances.Design, Setting, and ParticipantsThis retrospective cross-sectional study linked medical discharge and child protection system administrative data. The setting was Rady Children’s Hospital San Diego, a free-standing pediatric hospital in California. Participants included all emergency department and inpatient medical encounters involving children aged 12 years or younger with a positive urine drug test between 2016 and 2021. Statistical analysis was performed from February 2023 to January 2024.ExposureDrug type, including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, opiates, and phencyclidine.Main Measures and OutcomesCPS responses associated with the medical encounter including reports, substantiations, case openings, and out-of-home placements.ResultsA total of 511 emergency department and inpatient medical encounters involving children had a positive drug test (262 [51.3%] were female; 309 [60.5%] were age 6 years or younger; fewer than 10 [&lt;3.0%] were American Indian or Alaska Native; 252 [49.3%] were Hispanic [any race], 20 [3.9%] were non-Hispanic Asian, 56 [11.0%] were non-Hispanic Black, 143 [28.0%] were non-Hispanic White, 36 [7.0%] had other or unknown race and ethnicity; 233 [43.6%] had a CPS report prior to the medical encounter). Following the positive screen, 244 (47.7%) were reported to child protection, and 61 (11.9%) were placed out-of-home within 30 days. Mean (SD) quarterly counts of encounters with positive drug tests doubled after the COVID-19 pandemic onset (32.9 [9.8]) compared with prior to the pandemic onset (16.5 [4.7]); for encounters positive for cannabis, mean (SD) quarterly counts were 3 times as high after the pandemic onset than prior (16.6 [4.7] vs 5.7 [2.9]). Encounters for children under age 1 were significantly more likely to have associated child protection reports (relative risk [RR], 2.91 [95% CI, 2.21-3.83]) and child protection case openings (RR, 1.71 [95% CI, 1.07-2.72]) than encounters involving older children.Conclusions and RelevanceIn this cross-sectional study of emergency department and inpatient medical encounters, less than half of children with positive urine drug screens were reported to CPS; out-of-home placements were uncommon. With increased encounters for positive drug tests, it is unclear what services these children and families are receiving.

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“…These findings have been echoed in studies with child welfare workers and other service providers (Antwi-Boasiako et al, 2022;Cénat et al, 2021;. Findings like these have led Canadian scholars to argue that the disproportionate involvement of Black families in the child protection system is intrinsically connected to the history of race in North America, which has resulted in the system becoming characterized by anti-Black racism (Clarke et al, 2018;Hasford, 2015;Thobani, 2007).…”

Section: Institutional Practices -Mental Health Education and Legal S...mentioning

confidence: 99%

Understanding the over-representation of Black children in Ontario child welfare services

Bonnie,

Facey,

King

et al. 2023

Preprint

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This report describes maltreatment related investigations conducted in Ontario in 2018 that involved Black children and compares these investigations to those involving white children. These analyses present data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018), the sixth provincial study of maltreatment-related investigations conducted in the province. The report was prepared by the OIS-2018 Research Team at the request of One Vision One Voice, a program of the Ontario Association of Children’s Aid Societies.

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Understanding the overrepresentation of Black children in Ontario's child welfare system: Perspectives from child welfare workers and community service providers

Cited by 9 publications

References 37 publications

A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

A Qualitative Description of Resident Physicians’ Understanding of Child Maltreatment: Impacts, Recognition, and Response

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Understanding the over-representation of Black children in Ontario child welfare services

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