IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v11i5.3719 11:5:3719 S2399490821037198 Population Data Science Gender Inequality, Maternal Violent Injury, and Child’s Mental Health in Immigrant Families AndreiSorina1 HassBarbara2 BrownHilary3 WangXuesong4 FazioMarissa5 MataiLavina4 Hadipour-LakmehsariSina6 MaclaganLaura4 UrquiaMarcelo7 SaundersNatasha8 Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada; Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada ICES, Toronto, Canada; Sunnybrook Research Institute, Toronto, Canada ICES, Toronto, Canada; Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada; Edwin S.H. Leong Centre for Healthy Children, Toronto, Canada ICES, Toronto, Canada Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada; Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Canada; ICES, Toronto, Canada; The Hospital for Sick Children, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada 11 5 3719 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/3719 Background

When mothers experience assault, their children’s mental health may be impacted. We hypothesized that for children in immigrant families, the mental health impact of a mother’s assault may be exacerbated by a history of gender inequality in the mother’s birth country.

 Methods

This population-based cohort study included children (age<18) born in Ontario, Canada, 2002–2020, and their immigrant mothers. Children were categorized on two maternal exposures: assault and birth country Gender Inequality Index. The primary outcome was five-year risk of new/worsening child mental illness, evaluated as adjusted relative risks (aRR) using modified Poisson models controlling for baseline social and health characteristics. Adjusted relative excess risk due to interaction (aRERI) assessed the joint effects of both exposures.

 Results

We identified 90,251 children with neither maternal exposure, 246,485 exposed to maternal gender inequality only, 1,166 exposed to maternal assault only, and 4,723 with both. Compared to children with neither exposure, those exposed to both maternal outcomes had a higher five-year risk of mental illness (13.5% vs. 8.9%; aRR 1.36, 95%CI 1.26–1.48), as did those exposed to maternal violent injury only (14.7%; aRR 1.45, 95%CI 1.26–1.68), but not high gender inequality only (8.6%; aRR 0.98, 95%CI 0.95–1.00). Having both exposures produced a negative interaction for child mental illness (aRERI -0.07, 95%CI -0.20–0.05).

 Conclusion

While children whose immigrant mothers experienced violence or originated from a high-gender inequality country conferred a high risk of mental illness, the combination of these factors did not contribute to excess mental illness risk.