Tonino Esposito

Background: Racial disparities in child welfare involvement in Canada are well documented, but national rates of Black children living in foster homes and characteristics of their placements remain poorly understood. Understanding these patterns is important for informing equitable child welfare policy and practice.Objective: To examine rates and characteristics of foster home living among Black and White children in Canada from 2011 to 2021.Participants and Setting: Black and White children younger than 18 years identified by Census respondents as living in private dwelling foster homes were included from Canadian Census data in 2011, 2016, and 2021.Methods: This repeated cross-sectional study estimated national and provincial/territorial rates of private dwelling foster home living. Secondary outcomes included child, household, and placement characteristics, including socioeconomic indicators and racial, language, and religious discordance.Results: National rates among Black children declined from 5.25 per 1000 children in 2011 to 2.78 per 1000 in 2021 (P<.001). Black children had higher rates than White children in 2011 (RR, 1.59; 95% CI, 1.24-1.71) and 2016 (RR, 1.54; 95% CI, 1.38-1.74), but rates were similar in 2021 (RR, 0.99; 95% CI, 0.90-1.09). Provincial and territorial variation persisted. Across the decade, Black children were more likely to experience socioeconomic disadvantage and racial, language, and religious discordance within their foster households.Conclusions: National disparities in private dwelling foster home living narrowed from 2011 to 2021, but differences in placement context persisted. Findings highlight structural inequalities affecting Black families and the need for culturally responsive, community-informed, and anti-racist child welfare practices.

Children with intellectual disability (ID) experience disproportionate social and health adversities; however, population-level evidence integrating child protection and healthcare data remains scarce. We introduce the Child Development and Protection Pathways in Intellectual Disability (PROTECT) databank a province-wide linked administrative infrastructure in Québec, Canada, and report initial findings from a population-based retrospective longitudinal cohort study (N = 18,095). Using linked child protection records, physician billing claims, and hospitalization data, we identified children born between 2001 and 2016 and residing in six administrative regions. ID was defined using outpatient and inpatient diagnostic codes, and maltreatment was defined as at least one child protection report retained for evaluation before age 18. Children were classified into four mutually exclusive cohorts based on the presence or absence of ID and child maltreatment. We estimated the prevalence and cumulative burden of mental and physical health service use and compared cohorts using negative binomial regression models. Children with co-occurring ID and maltreatment experienced the highest cumulative burden of service use, whereas those with neither exposure had the lowest. Across outcomes, the presence of ID was the primary correlate of elevated burden, with the highest mental health burden among children with dual exposure. PROTECT establishes a scalable population-level resource to examine intersecting developmental and protection-related risks and provides actionable evidence to inform strategies aimed at reducing health inequities among children with developmental vulnerabilities.

Les jeunes en situation de sortie de placement lors de la transition à la vie adulte sont plus à risque d’être judiciarisés que les jeunes de la population générale du même âge. La sortie des milieux de placement se déploie dans un contexte de vulnérabilité sociale pouvant précipiter le passage des services en protection de la jeunesse vers le système de justice pénale pour adultes. En plus, certaines des caractéristiques liées à l’expérience de placement augmentent ces risques de judiciarisation. L’instabilité de placement et les milieux de placement de type centre d’hébergement contribuent au processus de judiciarisation pénale lors de la transition à la vie adulte. Compte tenu de la vulnérabilité dans laquelle s’effectue la sortie de placement, nous nous intéressons au rôle préventif des réseaux de soutien sur la judiciarisation des jeunes en sortie de placement au début de l’âge adulte. Plus précisément, nous examinons des effets d’interactions entre le réseau de soutien et les conditions de placement (milieu de placement et changements de milieu de vie) sur la judiciarisation au début de l’âge adulte. À ces fins, nous mobilisons les données de l’Étude sur le devenir des jeunes placés (EDJeP) du Québec. Nos analyses de régressions logistiques révèlent que les jeunes qui ont un réseau de soutien plus étendu sont moins à risque d’être judiciarisés au début de l’âge adulte. Nos résultats montrent également un effet de modération de l’étendue du réseau sur la judiciarisation au début de l’âge adulte en fonction de l’instabilité de placement. Cependant, on n’observe pas d’effet de modération en fonction du milieu de placement. Nos résultats suggèrent la mise en place de politiques qui prennent en considération les réseaux de soutien des jeunes en sortie de placement.