81 Rates and reasons for hospitalization of children and youth with foster home experience: A Pan-Canadian cohort study
Bibliographic record
Abstract
Abstract Background In Canada, an estimated 4-7% of children will be placed in a foster home during their childhood. First Nations children are 17 times more likely to be removed from their home compared to non-First Nations children due to the ongoing legacy of the Canadian Indian Residential School System, but there are no published data for Métis and Inuit children. Childhood trauma and caregiver disruption is associated with poor health and mental health outcomes, yet little is known about the healthcare use of these children across Canada. Objectives To determine the rates and conditions responsible for hospitalization of children with foster home experience across Canada. Design/Methods This is a cohort study of Canadian children < 18 years of age living in a foster home on the day of the 2011 Census. We determine the rate of hospitalization over 6 years (2011 to 2017) using Statistics Canada’s 2011 Canadian Census Health and Environment Cohorts, which links National Household Survey (NHS) (demographics), and the Discharge Abstract Database (hospitalization encounters). Indigenous status was identified by the respondent of the NHS. Survey weights were applied to render the results representative of the Canadian population. All provinces and territories in Canada except for Quebec were included. The University of Ottawa’s Research Ethics Board approved this study as exempt. Results After survey weights, our study represented 31,595 children in foster homes compared to 5,317,346 children not in foster homes. 50.5 per 1,000 of respondent-identified First Nations children lived in foster homes on the day of the Census compared to 3.3 per 1,000 of non-Indigenous and non-Racialized children (Table 1). Rates of living in foster home per 1,000 was 18.4 for Métis, 25.6 for Inuit, and 5.2 for Black children. Age standardized rates of hospitalization for children with foster home experience was 4.8 per 100 person-years, compared to 2.5 per 100 person-years for those without foster home experience, where hospitalization rates varied by age (Figure 1). 3% of children with foster home experience had 3 or more hospitalizations and were responsible for 49% of all hospitalizations in that population. The top conditions responsible for hospitalization for children with foster home experience were childbirth and mental health. Conclusion Our study, shared with national First Nations, Métis and Inuit agencies, indicate a substantial overrepresentation of First Nations, Métis, Inuit, and Black children in foster homes in Canada. These children face higher rates of youth pregnancies and mental health hospitalizations. As the preliminary data of one of three cohorts, these results indicate that further work is needed to expand collaborations and set research priorities to generate essential evidence on the health of this vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".