IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v9i5.1679 9:5:191 Impact of out-of-home care on children’s outcomes: A longitudinal cohort study using linked administrative data from Manitoba, Canada Brownell Marni 1 Frank Kayla 2 Nickel Nathan 1 Enns Jennifer 1 Flaten Lisa 1 Sinclair Stephanie 3 Decaire Elizabeth 3 Chartrand Jennifer 2 Sinclair Scott 4 Mayer Teresa 4 Nash Chris 4 Pfau Jamie 1 Durksen Anita 1 Scatliff Colette 1 Hunter Mikayla 1 Han Soomin 5 Patrick Stephaney 1 Casidsid Hera 1 Amjad Sana 1 Bennett Marlyn 6 Casiano Hygiea 1 Houston James 4 Bowler Laura 1 Stukel Therese 7 University of Manitoba Assembly of Manitoba Chiefs First Nations Health and Social Secretariat of Manitoba Government of Manitoba McGill University University of Calgary University of Toronto 18 09 2024 2024 9 5 1674 This work is licenced under a Creative Commons Attribution 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/1674 Introduction

To provide rigorous quantitative evidence about the impact of out-of-home care on children’s outcomes.

 Approach

Guided by an Advisory Circle of First Nations (FN) Knowledge Keepers and conducted in partnership with FN researchers, we used linked administrative data to identify all Manitoba children served by Child Protection Services (CPS) at FN agencies (FNA) and other agencies (OA) (2007-2018). We compared health, education, and legal system outcomes of those in care (FNA n=10,856; OA n=8,468) to those with protection concerns but not in care (FNA n=12,896; OA n=14,394). Using instrumental variable analysis with CPS agency rate of out-of-home care as the instrument, outcomes between groups were compared using 2-stage multivariate probit regressions adjusted for child and family factors.

 Results

Odds of teen pregnancy (FNA OR 3.69, 95% CI 1.40-9.77; OA 5.10 (1.83-14.25)), teen birth (FNA 3.23 (1.10-9.49); OA 5.06 (1.70-15.03)), and positive STI tests (FNA ns; OA 7.21 (3.63-14.32)) were higher and odds of vaccination at age 2 (FNA ns; OA 0.49 (0.29-0.80)) were lower for children in care than children not in care. Odds of being accused (FNA ns; OA 2.71 (1.27-5.75)), victim (FNA ns; OA 1.68 (1.10-2.56)), or charged with a crime (FNA ns; OA 2.68 (1.21-5.96)), and odds of being incarcerated (FNA 3.64 (1.95-6.80); OA 1.19 (1.19-8.04)) were higher for children in care.

 Conclusions

Out-of-home care negatively affects children’s health, social and legal system outcomes.

 Implications

CPS agencies should work with FN leaders to develop and implement strategies to reduce the number of children taken into care.