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