The absence of language: A critical race discourse analysis of Ontario's child welfare legislation and the impacts on Black families.

BACKGROUND: The research pertaining to racial disparities for Black families in child welfare is relatively limited in Canada. Recent research reveals that the overrepresentation of Black families in Canadian child welfare systems typically begins at the reporting or investigation stage and continues throughout the child welfare service and decision-making continuum. This research is occurring against the backdrop of increasing public acknowledgement of Canada's historic anti-Black policy-making and institutional relationships to Black communities. Though there is increased awareness about anti-Black racism, there has been limited exploration of the connection between anti-Black racism in child welfare legislation and how this policy generates disparities for Black families in both child welfare involvement and outcomes - this paper seeks to fill this gap in knowledge. OBJECTIVE: The objective of this paper is to explore the entrenchment of anti-Black racism within the child welfare system by critically assessing the language and absence of language within the guiding legislative and implementation policies. METHODS: Utilizing a critical race discourse analysis method, this study explores the entrenchment of anti-Black racism within the Ontario child welfare system by critically assessing the language and absence of language within the guiding legislative policies that shape practice for Black children, youth, and families. RESULTS: The findings revealed that though the legislation does not explicitly address anti-Black racism, there were instances where the legislation indicated that race and culture may be considered in responding to children and families. The lack of specificity, particularly in the Duty to Report, has the potential to contribute to disparate reporting and decision-making for Black families. CONCLUSIONS: Policy makers should acknowledge the history of anti-Black racism that informed the development of the legislation in Ontario and move towards tackling systemic injustices that disproportionately affect Black families. More explicit language will shape future policies and practices to ensure that the impact of anti-Black racism is considered across the child welfare continuum.

Addressing the overrepresentation of Black children in Ontario's child welfare system: insights from child welfare workers and community service providers.

BACKGROUND: The overrepresentation Black children experience in the child welfare system is well documented in the United States, but such studies are now emerging in Canada. In Ontario, there are few studies that address this issue concerning Black families. OBJECTIVE: This study is to explore the insights of child welfare workers and community service providers on how to potentially address Black children's overrepresentation in Ontario's child welfare system. PARTICIPANTS AND SETTING: Twenty-one child welfare workers from two child welfare organizations in Ontario that serves many Black families and thirteen community service providers in Toronto participated in the study. METHODS: Six focus groups were conducted with thirty-four participants. Audio recording from each of the focus groups was manually transcribed verbatim. We utilized constant comparison analysis to analyse the transcribed data. RESULTS: Potential solutions to overrepresentation that emerged from the focus group discussions included viewing Black families as experts of their own lives; increasing workforce diversity; educating referral sources and Black families on child welfare practices; subjecting referral sources to detailed questioning; stopping harmful record keeping on families; providing cultural sensitivity training and education; partnering with community organizations; and providing mentorship opportunities. CONCLUSIONS: The findings from this study emphasize the need for changes related to child welfare assessment tools, workforce development, and shifts in system orientation to address systemic racism and Black children's overrepresentation in the child welfare system.

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

BACKGROUND: The overrepresentation of Black children in the child welfare system is a social problem that has received longstanding attention in the United States, but has recently received increasing attention in Canada. OBJECTIVE: This qualitative study explores the findings of two quantitative studies (Antwi-Boasiako et al., 2020, 2021) in order to interpret them through the perspectives of child welfare workers and community service providers. The aim is to gain a deeper understanding on the potential factors that contribute to the overrepresentation of Black children in Ontario's child welfare system. PARTICIPANTS AND SETTING: The study involved twenty-one child welfare workers from two child welfare organizations in Ontario serving lots of Black families and thirteen community service providers in Toronto. METHODS: Six focus groups were completed with thirty-four participants. Each of the focus groups was audio recorded and manually transcribed verbatim. Constant comparison analysis was used to analyze the transcribed data. RESULTS: Themes that emerged from the study include the following concerns: racism and bias from referral sources; racism and bias from child welfare workers; lack of cultural sensitivity; lack of workforce diversity/training; lack of culturally appropriate resources; assessment tools; duty to report; fear of liability; lack of collaboration; and poverty. CONCLUSIONS: The results from this study reinforce the need to shift practice that acknowledges Black families as valuable stakeholders and experts of their own lives and involves them in the development and implementation of policies and practices that affect them.

Recurrent involvement with the Quebec child protection system for reasons of neglect: A longitudinal clinical population study.

Studies in several jurisdictions have found that families become recurrently involved with child protection systems most frequently for reasons of neglect. Child protection involvement for reasons of neglect is shown to correlate with various socioeconomic vulnerabilities. OBJECTIVE: This study, the largest of its kind in Canada, examines when and for whom recurring conditions of neglect were most likely to occur for all children involved with child protection in the province of Quebec over a span of fifteen years. PARTICIPANTS AND SETTING: Specifically, the study population includes all children whose ongoing child protection intervention in Quebec closed between 2002 and 2017 (N = 76,176). METHODS: This clinical population study uses a longitudinal research design drawing anonymized clinical administrative data from all of Quebec's child protection jurisdictions spanning 15 years, and Quebec data extracted from the 2011 Canadian National Household Survey to estimate socioeconomic vulnerability. RESULTS: Of the total population studied, 32.5 % (N = 24,816) experienced a recurrence of maltreatment during the study period, of which more than one third (N = 8707) experienced a recurrence for reasons of neglect. CONCLUSIONS: Because the association between socioeconomic vulnerability and recurrence of neglect indicates a gap in material and social supports-which child protection systems have neither the mandate nor the resources to fill-we propose additional avenues that we urge policymakers and practitioners to consider in supporting the demonstrated needs of these families.

Differences and disparities over time: Black and White families investigated by Ontario's child welfare system.

BACKGROUND: Black-White disparities in child welfare involvement have been well-documented in the United States, but there is a significant knowledge gap in Ontario about how and when these disparities emerge. OBJECTIVE: This paper compares incidence data on Black and White families investigated by Ontario's child welfare system over a 20-year period. METHODS: Data from the first five cycles of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) (1993-2013) were used to examine trends in child maltreatment investigations involving Black and White families. Incidence rates were calculated. T-tests were conducted to assess statistically significant differences between and within cycles. Population and decision-based enumeration approaches were also used to examine child welfare disparities. RESULTS: The incidence of investigations involving White families almost doubled between 1998 and 2003, but for Black families the incidence increased almost fourfold during the same period. These increases and the difference between Black and White families in 2003 were statistically significant. The results further indicate that Black families experience disparate representation in Ontario's child welfare system over time for most service dispositions. CONCLUSIONS: Several possible explanations are offered for the study's outcome, including changes in risk related to social safety net, the threshold for risk of harm, and bias and racist institutional policies and practices. This study invites policy-makers and child welfare authorities to rethink service delivery in addressing the disparate representation of Black families in the child welfare system.

Early Childbirth Among Foster Youth: A Latent Class Analysis to Determine Subgroups at Increased Risk.

CONTEXT: Research has documented elevated rates of early childbirth among adolescents who have spent time in foster care, and a better understanding is needed of the characteristics of vulnerable individuals and the circumstances of their time in care. METHODS: California birth records for 1999-2010 were probabilistically linked to state child welfare service records spanning the same date range to identify females aged 12-19 who had spent time in foster care and had had a first birth before age 20. Latent class analysis was used to identify subgroups based on age at most recent entry into care, length of this stay and three indicators of placement instability. The probability of a first birth being related to class membership was assessed as a distal outcome, and differences across classes were assessed using chi-square tests. RESULTS: Four distinct classes of foster youth were identified: Later Entry/High Instability (20% of individuals), Later Entry/Low Instability (43%), Earlier Entry/High Instability (12%) and Earlier Entry/Low Instability (25%). The probability of a first childbirth ranged from 31% (class 1) to 15% (class 4); classes 2 and 3 experienced moderate risk (23% and 24%, respectively). Two groups were further characterized by high rates of reentry into care, with 56% of class 1 and 41% of class 3 individuals experiencing more than one episode in care. CONCLUSIONS: Identifiable subgroups of female foster youth are at heightened risk of early childbirth and may benefit from early intervention, enhanced support and access to reliable, ongoing sexual and reproductive health care.

Factors associated with racial differences in child welfare investigative decision-making in Ontario, Canada.

Despite the substantial body of literature on racial disparities in child welfare involvement in the Unites States, there is relatively little research on such differences for Canadian children and families. This study begins to address this gap by examining decision-making among workers investigating Black and White families investigated for child protection concerns in Ontario, Canada. Using provincially representative data, the study assessed whether Black children were more likely than White children to be investigated by child welfare, if there was disparate decision-making by race throughout the investigation, and how the characteristics of Black and White children contribute to the decision to transfer to ongoing services. The results indicate that Black children were more likely to be investigated than White children, but there was little evidence to suggest that workers in Ontario child welfare agencies made the decision to substantiate, transfer to ongoing services, or place the child in out-of-home care based on race alone. Black and White children differed significantly with respect to child characteristics, characteristics of the investigation, caregiver risk factors, and socioeconomic circumstances. When adjusting for these characteristics, Black families had 33% greater odds (OR=1.33; 95% CI: 1.26, 1.40; p=<0.001) of being transferred to ongoing services compared to White families. Among Black families, the assessed quality of the parent-child relationship and severe economic hardship were the most significant and substantial contributors to the decision to provide child welfare services. Implications for practice, policy, and research are discussed.

First Births to Maltreated Adolescent Girls: Differences Associated With Spending Time in Foster Care.

Few studies have examined early parenting among girls receiving child welfare services (CWS) or disentangled the relationship between maltreatment, spending time in foster care, and adolescent childbirth. Using population-based, linked administrative data, this study calculated birth rates among maltreated adolescent girls and assessed differences in birth rates associated with spending time in foster care. Of the 85,766 girls with substantiated allegations of maltreatment during adolescence, nearly 18% subsequently gave birth. Among girls who spent time in foster care, the proportion was higher (19.5%). Significant variations ( p < .001) were observed in the rate of childbirth across demographic characteristics and maltreatment experiences. When accounting for all of the covariates, spending time in foster care was associated with a modestly higher rate of a first birth (Hazard Ratio [HR] = 1.10; 95% confidence interval = [1.06, 1.14]). While age at first substantiated allegation of maltreatment and race/ethnicity were significant predictors of adolescent childbirth, specific maltreatment experiences were associated with minimal or no differences in birth rates. The findings of this study suggest that the experience of spending time in care may not be a meaningful predictor of giving birth as a teen among CWS-involved adolescent girls and highlight subgroups of this population who may be more vulnerable to early childbirth.

Predictors of Early Childbirth Among Female Adolescents in Foster Care.

PURPOSE: Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. METHODS: A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics. RESULTS: Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p < .001) in birth rates were observed across demographic characteristics, maltreatment history, and foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American. CONCLUSIONS: The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being.

A population-level and longitudinal study of adolescent mothers and intergenerational maltreatment.

For teenage mothers in California, we generated population-level estimates of the relationship between maternal history of maltreatment and next-generation abuse and neglect. California birth records for all infants born to primiparous teen mothers in 2006 or 2007 were linked to statewide child protective services (CPS) records. For each birth, we used CPS records to document 1) whether the teen mother had a history of reported or substantiated maternal maltreatment at or after age 10 years and before the estimated date of conception and 2) whether the teen's child was reported or substantiated for maltreatment before age 5 years. We fitted multivariable survival models to examine the association between a teenage mother's CPS involvement and child maltreatment, after adjusting for a range of sociodemographic variables. Our final data set included 85,084 births to first-time mothers aged 15-19 years. Significantly heightened rates of abuse and neglect were observed for children of mothers who had been reported to CPS as possible victims of maltreatment (P < 0.001). After adjustment for other risk factors, a maternal history of either unsubstantiated (hazard ratio = 2.19, 95% confidence interval: 2.06, 2.33) or substantiated (hazard ratio = 3.19, 95% confidence interval: 3.00, 3.39) maltreatment emerged as a strong predictor of maltreatment and CPS involvement in the next generation.

Building Analytic Capacity and Statistical Literacy Among Title IV-E MSW Students.

Building and sustaining effective child welfare practice requires an infrastructure of social work professionals trained to use data to identify target populations, connect interventions to outcomes, adapt practice to varying contexts and dynamic populations, and assess their own effectiveness. Increasingly, public agencies are implementing models of self-assessment in which administrative data are used to guide and continuously evaluate the implementation of programs and policies. The research curriculum described in the article was developed to provide Title IV-E and other students interested in public child welfare systems with hands-on opportunities to become experienced and "statistically literate" users of aggregated public child welfare data from California's administrative child welfare system, attending to the often missing link between data/research and practice improvement.

Cumulative teen birth rates among girls in foster care at age 17: an analysis of linked birth and child protection records from California.

This study used linked foster care and birth records to provide a longitudinal, population-level examination of the incidence of first and repeat births among girls who were in foster care at age 17. Girls in a foster care placement in California at the age of 17 between 2003 and 2007 were identified from statewide child protection records. These records were probabilistically matched to vital birth records spanning the period from 2001 to 2010. Linked data were used to estimate the cumulative percentage of girls who had given birth before age 20. Birth rates and unadjusted risk ratios were generated to characterize foster care experiences correlated with heightened teen birth rates. Between 2003 and 2007 in California, there were 20,222 girls in foster care at age 17. Overall, 11.4% had a first birth before age 18. The cumulative percentage who gave birth before age 20 was 28.1%. Among girls who had a first birth before age 18, 41.2% had a repeat teen birth. Significant variations by race/ethnicity and placement-related characteristics emerged. Expanded data and rigorous research are needed to evaluate prevention efforts and ensure parenting teens are provided with the needed services and supports.

Examining the evidence: reporter identity, allegation type, and sociodemographic characteristics as predictors of maltreatment substantiation.

Using linked administrative data from child protection and birth records in California, this study examined whether the mandated status and type of reporter are independent predictors of substantiation among infants and young children across maltreatment types and after adjusting for characteristics of the child and family. Of the 59,413 children born in 2002 who were reported and investigated for maltreatment before the age of 5 years, 26% were substantiated. Reports originating from mandated sources were 2.5 times as likely (95% confidence interval, CI [2.40, 2.60]) to be substantiated as those from nonmandated reporters. Findings demonstrated that children whose allegations were reported by law enforcement, medical professionals, and workers in public agencies were consistently substantiated at higher rates than allegations from other mandated reporters. Results also indicated that the relationship between reporter type and the likelihood of substantiation varied by maltreatment type. Children reported by law enforcement for physical abuse were 6.3 times as likely (95% CI [4.86, 8.04]) to be substantiated as those reported by nonmandated sources.

A population-based examination of maltreatment history among adolescent mothers in California.

PURPOSE: To document the abuse and neglect histories of adolescent mothers using official child protection records. METHODS: Vital birth records were used to identify adolescents 12-19 years of age who were born in California and gave birth in 2009. These records were linked to statewide child protective service data to determine maternal history of alleged and substantiated maltreatment victimization, as well as placement in foster care. RESULTS: A total of 35,098 adolescents gave birth in 2009. Before conception, 44.9% had been reported for maltreatment, 20.8% had been substantiated as victims, and 9.7% had spent time in foster care. CONCLUSIONS: These population-based data indicate that many adolescent mothers have had contact with child protective services as alleged or substantiated victims of abuse or neglect. Understanding the impact of childhood and adolescent maternal maltreatment on both early childbearing risk and subsequent parenting capacity is critical to the development of responsive service interventions.

Infant birth weight and maltreatment of adolescent mothers.

BACKGROUND: Emerging literature suggests that maternal exposure to stress and adversity throughout the life course may have health consequences for offspring. PURPOSE: To examine the maltreatment history of adolescent mothers as an independent predictor of infant birth weight. METHODS: Birth records for all infants born between 2007 and 2009 to mothers aged 12-19 years were extracted from California's vital statistics files. Maternal information from the birth record was linked to child protection data (1999-2009) to identify young mothers with substantiated maltreatment. Generalized linear models run in 2012 were used to estimate the relationship between maternal maltreatment and infant birth weight, after adjusting for maternal sociodemographic risk factors and health behaviors. RESULTS: Among the 153,762 singleton infants born to adolescent mothers, 7.1% (n=10,886) weighed <2500 g at birth. Of all adolescent mothers, 13.6% had been substantiated as victims of maltreatment after age 10 years and before giving birth. After adjusting for known factors predictive of negative birth outcomes, maltreatment history was associated with a slight yet significantly increased risk of low birth weight among infants (risk ratio=1.06, 95% CI=1.01, 1.12). CONCLUSIONS: Findings from this study suggest that maltreatment history of adolescent mothers is associated with infant low birth weight (<2500 g). Although the increased risk was small and the mechanism unclear, these data indicate that maternal maltreatment not only may have consequences for the victim but also may contribute to intergenerational health disparities.

Racial and ethnic disparities: a population-based examination of risk factors for involvement with child protective services.

OBJECTIVE: Data from the United States indicate pronounced and persistent racial/ethnic differences in the rates at which children are referred and substantiated as victims of child abuse and neglect. In this study, we examined the extent to which aggregate racial differences are attributable to variations in the distribution of individual and family-level risk factors. METHODS: This study was based on the full population of children born in California in 2002. Birth records were linked to child protective service (CPS) records to identify all children referred for maltreatment by age 5. Generalized linear models were used to compute crude and adjusted racial/ethnic differences in children's risk of referral, substantiation, and entry to foster care. RESULTS: As expected, stark differences between Black and White children emerged in the rates of contact with CPS. Black children were more than twice as likely as White children to be referred for maltreatment, substantiated as victims, and enter foster care before age 5. Yet, there were also significant differences across racial/ethnic groups in the distribution of socioeconomic and health factors strongly correlated with child maltreatment and CPS involvement. After adjusting for these differences, low socioeconomic Black children had a lower risk of referral, substantiation, and entry to foster care than their socioeconomically similar White counterparts. Among Latinos, before adjusting for other factors, children of U.S.-born mothers were significantly more likely than White children to experience system contact, while children of foreign-born mothers were less likely to be involved with CPS. After adjusting for socioeconomic and health indicators, the relative risk of referral, substantiation, and foster care entry was significantly lower for Latino children (regardless of maternal nativity) compared to White children. CONCLUSIONS: Race and ethnicity is a marker for a complex interaction of economic, social, political, and environmental factors that influence the health of individuals and communities. This analysis indicates that adjusting for child and family-level risk factors is necessary to distinguish race-specific effects (which may reflect system, worker, or resource biases) from socioeconomic and health indicators associated with maltreatment risk. Identifying the independent effects of these factors is critical to developing effective strategies for reducing racial disparities.

A field experiment in capitated payment systems and recovery management: the women's recovery association pilot study.

Against the backdrop of shifting perspectives regarding substance abuse policy, upcoming changes to the health care system, and progress toward parity for mental health and substance abuse treatment, an exploratory pilot study is being conducted in San Mateo County, California, to assess the potential of a capitated case rate combined with a recovery management approach in a community-based substance abuse treatment program for women. The rationale for developing the approach, planning, and implementation of the pilot project, the struggle of the agency to transform from episodic treatment to a chronic care model, and a case study that highlights organizational changes are discussed. Lessons learned and implications for the second year of the pilot project are also discussed.