Untangling Maltreatment and Poverty: Lessons from the Ontario Incidence Study of Child Abuse and Neglect-2013

Background/Purpose:
There is strong evidence that poverty and child maltreatment are closely related; however, the etiology of this relationship is not well understood in either the child welfare literature or child welfare practice. Greater understanding of this complex relationship is necessary for the development of efficacious interventions. The Ontario Incidence Study of Reported Child Abuse and Neglect-2013 (OIS-2013) presents a unique opportunity to understand the relationship of poverty to maltreatment. In the 2013 cycle of the study, proxy measures of poverty were developed, partly in response to low response rates for direct income measures in previous cycles. Child protection workers were asked to identify if the household had run out of money for food, housing, and/or utilities in the past six months. This paper examines the relationship of these proxy measures of poverty to the decision to substantiate child maltreatment and transfer a case to ongoing child welfare services.

Methods:
The OIS-2013 is the fifth provincial study to examine the incidence of reported maltreatment and the characteristics of children and families investigated by child welfare authorities in Ontario. Information was collected directly from child protection workers on a representative sample of child protection investigations across Ontario in the fall of 2013. This sample was then weighted to reflect provincial annual estimates. In this paper, secondary analyses of OIS-2013 data were conducted. First, bivariate analyses were conducted on all key clinical variables related to maltreatment. All bivariate chi-square estimates were adjusted for artificial inflation by using a sample weight. Only statistically significant variables were entered into the logistic regressions. Cut points were changed to reflect the overall rate of substantiation in the sample (40%) and transfer to ongoing services (30%).

Results:
There were an estimated 125,281 investigations in Ontario in 2013. In seven percent of investigations, the worker indicated that the household ran out of money for food in the past six months. In four percent of investigations the household ran out of money for housing, and in five percent, the household ran out of money for utilities. Predictably, neglect investigations were almost three times more likely to have a concern noted for food, housing or utilities: almost 15% of neglect investigations noted one of these concerns. When controlling for key clinical concerns including maltreatment type, emotional and physical harm, as well as the functioning concerns of the primary caregiver, investigations with a noted concern of poverty were 2 times more likely to be substantiated (OR 1.99) and 3 times more likely to be transferred to ongoing child welfare services (OR 2.87).

Conclusions and Implications:
These results indicate that while families identified to the child welfare system struggle with parenting, they also struggle with the provision of basic necessities for their children. The challenge is to address the immediate concerns of these families in addition to addressing the safety of children and promoting their well-being. While investigations involving poverty concerns were three times more likely to receive a referral to an external service, the efficacy of these supports remain unclear.