Out-of-Home Placement and Socioeconomic and Funding Disparities: A Multilevel Analysis

Background/Purpose: Although poverty and lack of social support are well established risk factors for child maltreatment, far less is known about the extent to which the provision of social services or poverty reduction policies might mitigate this relationship. The province of Quebec has been one of the most socially progressive jurisdictions in North America, offering an array of poverty reduction and family support services, ranging from universal free health care, subsidized public child care, and a very progressive income tax redistribution system. Despite these policies, socioeconomic disadvantages continue to be important risk factors for child maltreatment and subsequent out-of-home placement. Beyond the influence of neighborhood socioeconomic disadvantages already demonstrated in a previously published provincial longitudinal analysis, this study exams the extent to which regional disparities in neighborhood socioeconomic vulnerabilities and health and social service funding impact the risk of placement, after controlling for individual-level risk factors and regional latent differences in delivery of child protection services.

Method: This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies, (2) 2006 Canadian Census data and (3) intra-province health and social service spending data. The clinical population studied consists of all children (N = 127,181) investigated for maltreatment for the first time between April 1, 2002 and March 31, 2010, followed for a minimum of 18 months from their initial child maltreatment investigation. Out-of-home placement is the dependent variable in this study. Covariates examined at the first level include age at initial investigation, ethno-racial background, gender, reason for investigation, number of investigations, source of the referral and request for youth criminal justice services. Regional neighborhood socioeconomic disadvantages and public funding for health and social services are examined at the second level.

Results: This study suggests that regional disparities in neighborhood socioeconomic vulnerabilities and a relative lack of funding for health and social services contribute to the increased risk of placement for younger children. Specifically, this study revealed that neighborhood socioeconomic disadvantages and funding for services account for close to fifty percent of the variation in regional placement rates for younger children investigated primarily because of neglect and parents’ high-risk lifestyle. Whereas for older children investigated primarily for behavioural problems – neighborhood socioeconomic disadvantages and funding for services did not significantly explain variations in regional placement rates.

Conclusions and Implications: Although Quebec provides a range of preventative services to support vulnerable families, socioeconomic and funding factors continue to matter to the extent that they predict the removal and placement of young children in out-of-home care.  In this context, this study suggests promising ways of ensuring that a supportive structure, integrating community partners and services needed to support child protection intervention, is in place in order to be proactive in addressing family difficulties.