MHST 601: Health Disparities of Indigenous Children and Youth in Alberta's Child Intervention System

As a former advocate for Alberta’s Office of the Child and Youth Advocate (OCYA) who has provided advocacy supports for children and youth in care, I have an interest in the health and wellbeing of young people receiving child intervention services. During my time with the office, I worked with numerous young people; the majority of whom were Indigenous. Some of these individuals were injured while receiving child intervention services (in or outside of their home) and continue to live with trauma-related mental health, addictions and other chronic issues. This blog post focuses on the child intervention rates of Indigenous children in comparison to their non-Indigenous counterparts and explores the rates of injury and death of young people in care.

Child maltreatment is a global problem; extreme cases can result in a serious injury or death. Approximately 3 in 4 children aged 2 to 4 years have been physically and/or psychologically abused by their parents or caregivers. 1 in 5 women and 1 in 13 men report they were sexually abused as a child (0-17 years). Child abuse survivors are more likely to perpetrate against children as adults, which means these actions can have multi-generational consequences. The majority of child abuse cases go unreported, so the actual number of cases is unknown (WHO. Child Maltreatment, n.d.).

Across Canada, an estimated 299,217 child maltreatment investigations were conducted in 2019. 45,918 (15%) involved First Nations children and 241,137 (81%) involved non-Indigenous children. Given that Indigenous children only make up 7.7 per cent of children aged 0-14 years, they are 3.6 times more likely to be maltreated when compared to their non-Indigenous counterparts (Fallon, B., et al., 2022, p.7). As of 2022, approximately 9,451 children and youth in Alberta received child intervention services. 7,825 young people were apprehended from their home, while 1,626 received in-home supports (Child Intervention Statistics | Alberta.Ca, n.d., ; Hobson, 2022).

The following chart provides a breakdown of the monthly average distribution of legal authorities for young people receiving child intervention services under the Child, Youth and Family Enhancement Act (CYFEA).

As illustrated, a disproportionate number of children and youth in care are Indigenous and they are more likely to be permanently removed from their family home.

The next graph shows the monthly child intervention rates for Indigenous and non-Indigenous children since 2013.

Although there was a slight decline in 2015/16, it is evident that apprehension rates for Indigenous young people are on the rise, whereas rates for their non-Indigenous counterparts are significantly lower and have been declining since 2020/21. The pandemic does not appear to have played a significant role in altering the statistics for Indigenous young people. In comparison, non-Indigenous young people's status rates are declining since the pandemic. The complete data set can be viewed here.

The OCYA, an independent body of the Alberta’s Legislative Assembly, conducts death and serious injury investigative reviews for young people who are actively receiving services under CYFEA. (Serious injuries are defined as life-threatening or causing significant long-term health impairments.) In 2022, they released a report that summarized 10 years of investigations which included findings, trends and published recommendations from 554 death notifications and 80 notifications of serious injuries. I have provided highlights of their findings below.

Notifications of serious injury or death by age

This chart shows the number of deaths and serious injuries for young people aged 0-24 years. As noted, the majority of cases involved children aged 12-17 years. Young people between the ages of 7-11 years were the least impacted cohort.

Notifications received for Indigenous versus non-Indigenous young people

This chart illustrates the number of cases involving Indigenous and non-Indigenous children and youth. As noted there were 634 cases, 57% of which involved Indigenous children and youth.

Notifications by type of injury or death

These charts explain the causes of death and serious injury. The main causes of death were linked to medical issues, whereas the primary cause of serious injury was violence, which is alarming, given these young people were actively receiving child intervention involvement when the incidence occurred.

To address the disparities, the report recommends:

• Strengthened child intervention assessments;

• Improved collaboration and coordination of child-serving systems;

• Increased access to services and supports; and

• Culturally appropriate, targeted services that address complex needs such as disabilities, trauma, mental health and substance use.

Conclusion

Having worked directly with many Albertan children and youth for several years, it was very disappointing to review the current statistics and see that the health disparities for children overall and for Indigenous young people in particular, remain at an all time high. Despite numerous studies and upgrades to casework practice in Alberta such as the introduction of the Child Intervention Practice Framework and Signs of Safety, the health and social disparities have not changed. Historic and current systemic issues, multigenerational poverty, exclusion and racism continue to negatively impact the health outcomes of children and youth provincially, nationally and on a global level (Navia et al., 2018). A multilevel approach and political will are needed to comprehensively address this complex issue.

REFERENCES

Alberta.ca. Child and Youth Advocate 10-year investigations summary. Retrieved November 11, 2023, from https://www.ocya.alberta.ca/wp-content/uploads/2014/08/OCYA_10-year-investigation-summary-final.pdf

Child and Youth Advocate releases Summary Report: 10 Years of Investigations | Office of the Child and Youth Advocate. (n.d.). Retrieved November 11, 2023, from https://www.ocya.alberta.ca/adult/news/child-and-youth-advocate-releases-summary-report-10-years-of-investigations/

Government of Alberta. Child Intervention Data Tool (N.d.). Retrieved November 11, 2023, from https://visualizations.alberta.ca/SASVisualAnalytics/?reportUri=%2Freports%2Freports%2F318dbaa6-9e23-43c0-ad8d-a68fa9b49c6e&sectionIndex=0&sso_guest=true&reportViewOnly=true&reportContextBar=false&sas-welcome=false

Government of Alberta. Child intervention information and statistics summary child intervention information and statistics -2022-23 third quarter (December) update, n.d.) https://open.alberta.ca/dataset/de167286-500d-4cf8-bf01-0d08224eeadc/resource/99ca1767-7da1-48bf-b77e-c1a1aa772dd6/download/cs-child-intervention-information-and-statistics-summary-2022-2023-q3.pdf

Hillis, S., Mercy, J., Amobi, A., & Kress, H. (2016). Global Prevalence of Past-year Violence Against Children: A Systematic Review and Minimum Estimates. Pediatrics, 137(3), e20154079. https://doi.org/10.1542/peds.2015-4079

Navia, D., Henderson, R. I., & First Charger, L. (2018). Uncovering Colonial Legacies: Voices of Indigenous Youth on Child Welfare (Dis)Placements. Anthropology & Education Quarterly, 49(2), 146–164. https://doi.org/10.1111/aeq.12245

Office of the Child and Youth Advocate. (n.d.). Retrieved November 11, 2023, from https://www.ocya.alberta.ca/

Press ·, Hobson. B. The Canadian. “More than Half the Children in Care Are Indigenous, Census Data Suggests | CBC News.” CBC, 21 Sept. 2022, https://www.cbc.ca/news/canada/manitoba/census-indigenous-children-care-1.6590075