Do socioeconomic and birth order gradients in child maltreatment differ by immigrant status

Bibliographic Data

ID11180208
AuthorsKathleen S Kenny (0000-0001-9531-5213, University of Manitoba, corresponding author), Aleksander Pulver (0000-0001-7010-8496, University of Toronto), Ariel Pulver (University of Toronto), Patricia O’campo (0000-0003-4549-7324, University of Toronto), Astrid Guttmann (0000-0001-8177-2253, Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada), Marcelo L Urquia (0000-0002-8289-8090, University of Manitoba)
Year2021
Volume75
Issue1
Pages22-28
Publication date2021-01-01
Open AccessYes
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech-2019-212759
PMID32938615
OpenAlexW3084634393
LanguageEN
Citations received1
References cited34

Background While literature has documented strong gradients in child maltreatment (CM) by socioeconomic status and family composition in the general population, how these patterns extend to immigrants remain inconclusive. Using population-based administrative data, we examined, for the first time, whether gradients in CM by neighbourhood income and childbirth order vary by immigrant status. Methods We used linked hospitalisation, emergency department visits, small-area income, birth and death records with an official Canadian immigration database to create a retrospective cohort of all 1 240 874 children born from 2002 to 2012 in Ontario, Canada, followed from 0 to 5 years. We estimated rate ratios of CM among immigrants and non-immigrants using modified Poisson regression. Results CM rates were 1.6 per 100 children among non-immigrants and 1.0 among immigrants. CM was positively associated with neighbourhood deprivation. The adjusted rate ratio (ARR) of CM in the lowest neighbourhood income quintile versus the highest quintile was 1.57 (95% CI 1.49 to 1.66) for non-immigrants and 1.33 (95% CI 1.15 to 1.54) for immigrants. The socioeconomic gradient disappeared when restricted to children of immigrant mothers arrived at 25+ years and in analyses excluding emergency department visits. Compared to a first child, the ARR of CM for a fourth or higher-order child was 1.75 (95% CI 1.63 to 1.89) among non-immigrants and 0.57 (95% CI 0.44 to 0.74) among immigrants. Conclusions Immigrants exhibited lower CM rates than non-immigrants across neighbourhood income quintiles and differences were greatest in more deprived neighbourhoods. The contrasting birth order gradients between immigrants and non-immigrants require further investigation

Birth order · Environmental health · Immigration · Injury prevention · Occupational safety and health · Pathology · Poison control · Population · Socioeconomic status · Suicide prevention · Child Abuse and Trauma · Demography · Homicide, Infanticide, and Child Abuse · Human Factors and Ergonomics · Medicine · Migration, Health and Trauma · Pediatrics

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