relationship between socioeconomic status and child abuse and neglect in south australia
TRANSCRIPT
Relationship between Socioeconomic Status and child abuse and neglect in
South Australia
Background
• Neighbourhood characteristics such as socio-economic status (SES) have been shown to correlate with poorer health outcomes, mortality rates, childhood development, and education
• Previous studies suggested that the SES of a neighbourhood may be related to rates of childhood abuse and neglect– These did not answer our questions
This Study
• Exploration of the relationship between SES and rates of childhood abuse and neglect in South Australia (SA)
• CP Data from 3 one-year periods (2006/07 to 2008/09)
• Incidence data at population level (Statistical Local Area (SLA))– Data aggregated to SLA level
This Study
• Research questions:– What is the relationship between socio-
economic status and rates of childhood abuse and neglect in SA?
– What areas of SA have observed rates of abuse and neglect which are above or below those expected based on their SES?
– Which measurements of disadvantage indicate a relationship with rates of child abuse and neglect?
SEIFA
• SES represented by Socio-Economic Indexes for Areas (SEIFA)
• SEFIA produced by the ABS from 2006 Census data
• Index of relative disadvantage used– 17 items from Census indicate the level of
disadvantage in the SLA
Population of areas
• Data from 121 SLA’s across SA included
• Large variation in number of children living in these SLA’s
• Population aged 0 to 17 years (from 2006 Census)– Total population 0 to 17 = 341,561– Average = 2,823 (SD 2,119)– Range = 29 to 8,641
Rates of childhood abuse and neglect
• Childhood abuse and neglect data have been averaged over the three data periods and reported as per year
• Represents the incidence of children who have contact with the child protection system across SA per year
• CP data aggregated by SLA of where a child was living when the incident occurred
Statistical analysis
• Associations between SEIFA and rates of childhood abuse and neglect were estimated using Negative Binomial regression models
• Can account for a number of issues when analysing count data at a population level
• Models can estimate the relative difference in rates between and within predictors
Interpretation of results
• Cross-sectional study
• Can identify relationships between level of disadvantage characteristics and rates of childhood abuse and neglect
• However, causal links can not be established
Limitations
• Population at risk over the three data years take from 2006 Census (ie no population growth)
• Level of disadvantage may vary within a SLA
Distribution of rate of children subject to a notification across SLA’s
Rate of 39.3 per 1,000 children per year across all SLAs
Distribution of rate of children to experience a substantiation across SLA’s
Rate of 5.2 per 1,000 children per year across all SLAs
Rate of children subject to a notification
0
10
20
30
40
50
60
70
80
90
100
1 (most) 2 3 4 5 6 7 8 9 10 (least)
Ra
te p
er
1,0
00
ch
ildre
n p
er
ye
ar
SEIFA - Index of Disadvantage (decile)
Rate of children subject to a notification by primary type
0
5
10
15
20
25
30
35
40
1 (most) 2 3 4 5 6 7 8 9 10 (least)
SEIFA - Index of Disadvantage (decile)
Ra
te p
er
1,0
00
ch
ild
ren
pe
r y
ea
r
sexual notifications physical notifications neglect notifications
emotional notifications non-incident notifications
Rate of children to experience a substantiation
0
2
4
6
8
10
12
14
16
1 (most) 2 3 4 5 6 7 8 9 10 (least)
Ra
te p
er
1,0
00
ch
ildre
n p
er
ye
ar
SEIFA - Index of Disadvantage (decile)
Rate of children to experience a substantiation by primary type
0
1
2
3
4
5
6
1 (most) 2 3 4 5 6 7 8 9 10 (least)
SEIFA - Index of Disadvantage (decile)
Ra
te p
er
1,0
00
chil
dre
n p
er
yea
r
sexual substantiation physical substantiation neglect substantiation
emotional substantiation other substantiation
Cultural background
• Indigenous children were more likely to be subject to a notification– 228 per 1000 Indigenous children per year– 34 per 1000 non-Indigenous children per year
• And experience a substantiation– 48 per 1000 Indigenous children per year– 3.9 per 1000 non-Indigenous children per
year
Cultural background
• Comparison of the association of the level of disadvantage and rate of childhood abuse and neglect within SLAs between Aboriginal and/or Torres Strait Islander children and non-Indigenous was explored
Rate of children subject to a notification by cultural background
0
50
100
150
200
250
300
1 (most) 2 3 4 5 6 7 8 9 10 (least)
SEIFA Index of Disadvantage
Ra
te o
f c
hild
ren
su
bje
ct
to a
no
tifi
cati
on
(p
er 1
000
pe
r y
ear)
Indigenous non Indigenous
Rate of children to experience a substantiation by cultural background
0
10
20
30
40
50
60
70
1 (most) 2 3 4 5 6 7 8 9 10 (least)
SEIFA Index of Disadvantage
Ra
te o
f c
hild
ren
to
ex
per
ien
ce
a s
ub
sta
nti
atio
n (
pe
r 1
000
p
er
yea
r)
Indigenous non Indigenous
Expected rates based on SES
• The models can calculate expected rates of children subject to a notification or substantiation based on the level of disadvantage of where they live
• Comparison of the observed and expected rates can indicate the how well a rate for a SLA can be explained by the level of disadvantage within the SLA
Rate of children subject to a notification (per 1000 per year)
10 20 50 100 200 500
-1.0
-0.5
0.0
0.5
1.0
1.5
Expected rate of children subject to a notification (per 1000 per year)
De
via
nce
re
sid
ua
l
Rate of children to experience a substantiation (per 1000 per year)
1 2 5 10 20 50 100
-2-1
01
23
Expected rate of children to experience a substantation (per 1000 per year)
De
via
nce
re
sid
ua
l
SEIFA items
• The Index of Disadvantage contains 17 items
• Data on 16 of these items were collected for each SLA at population level– % of dwellings requiring one or more extra
bedrooms not available
• The next section explored the association of these items individually with rates childhood abuse and neglect
SEIFA items
Income low % people with stated annual household equivalised income between $13,000 and $20,799
No Qual % people aged 15 years and over with no post-school qualifications
No School % people aged 15 years and over who did not go to school
Unemployed % people (in the labour force) unemployed
Occ Labour % employed people classified as Labourers
Occ Drivers % employed people classified as Machinery Operators and Drivers
Occ Service L % employed people classified as Low skill community and Personal service workers
Rent Social % households renting from a Government or Community organisation
SEIFA items
Low Rent % households paying rent who pay less than $120 per week
One Parent % families that are one parent families with dependent offspring only
No Car % occupied private dwelling with no car
Divorced % people aged 15 years and over who are separated or divorced
Indigenous % people who identified themselves as being of Aboriginal and/or Torres Strait Islander origin
English Poor % people who do not speak English well
No Net % occupied private dwellings with no Internet connection
Disability U70 % people aged under 70 who need assistance with core activities
Associations with rate of children subject to a notification (121 SLAs)
• The following items were significantly associated with increased rates of children subject to a notification per year:– Income low, No Qual, Unemployed, Occ
labour, Occ driver, Occ service L, Rent social, Low rent, One parent, No car, Divorced, Indigenous, English poor, No net, Disability U70
• While, no significant association with– No school
% Indigenous by rate of children subject to a notification
0.2 0.5 1.0 2.0 5.0 10.0 20.0 50.0
05
01
00
15
02
00
25
03
00
% People who indentified as being Aboriginal and/or Torres Strait Islander origin (logged)
Ra
te o
f ch
ildre
n s
ub
ject
to a
no
tific
atio
n (
pe
r 1
00
0 p
er
yea
r)Size of circle represents size of population aged 0-17
Associations with rate of children to experience a substantiation (121 SLAs)
• The following items were significantly associated with increased rates of children to experience a substantiation per year:– No Qual, Occ labour, Occ driver, Occ service
L, Rent social, Low rent, No car, Divorced, Indigenous, English poor, No net, Disability U70
• While, no significant association with– Income low, No school, Unemployment, One
parent
% Indigenous by rate of children to experience a substantiation
0.2 0.5 1.0 2.0 5.0 10.0 20.0 50.0
02
04
06
08
01
00
% People who indentified as being Aboriginal and/or Torres Strait Islander origin (logged)
Ra
te o
f ch
ildre
n to
exp
eri
en
ce a
su
bst
an
tatio
n (
pe
r 1
00
0 p
er
yea
r)Size of circle represents size of population aged 0-17
Summary
• Strong positive relationship between the level of disadvantage where children live and the reported rates of childhood abuse and neglect in that community at a population level
• Stronger relationships for emotional abuse and neglect (both alleged and confirmed abuse)
• Higher rates for Indigenous children regardless of level of disadvantage