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

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• 作者：Melissa O&rsquo ; Donnell^a ; ^{Melissa.O'Donnell@telethonkids.org.au" class="auth_mail" title="E-mail the corresponding author} ; Miriam Maclean^a ; ^{Miriam.Maclean@telethonkids.org.au" class="auth_mail" title="E-mail the corresponding author} ; Scott Sims^a ; ^{Scott.Sims@telethonkids.org.au" class="auth_mail" title="E-mail the corresponding author} ; Marni Brownell^b ; ^{marni_brownell@cpe.umanitoba.ca" class="auth_mail" title="E-mail the corresponding author} ; Okechukwu Ekuma^c ; ^{oke_ekuma@cpe.umanitoba.ca" class="auth_mail" title="E-mail the corresponding author} ; Ruth Gilbert^d ; ^{r.gilbert@ich.ucl.ac.uk" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Out-of-home care ; Cumulative incidence ; Risk factors
• 刊名：Child Abuse & Neglect
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：59
• 期：Complete
• 页码：78-87
• 全文大小：806 K

文摘

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 (<3 years 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.