Data suggest greater inequity for racialized young Canadians

Data focused exclusively on Canadian children reveal stark differences in the experiences of racialized children compared with non-racialized children — from infancy through adolescence. For example, infant mortality is 3.9 times higher for Inuit, 2.3 times higher for First Nations and 1.9 times higher for Métis children compared with non-Indigenous children.

As well, the rate of foster placements is over 13 times higher for Indigenous young people compared with non-Indigenous. Similarly, while Black children make up about 9% of the Canadian population, they represent approximately 24% of children receiving child protection services.

Racialized Canadian children may also experience greater hardships and disparities in the education system. For example, while high-school graduation rates for Indigenous young people have increased substantially over the past 15 years in BC, they are still lower than other youth — at 69.6% for Indigenous students versus 86.5% for non-Indigenous. As well, Ontario data collected over the past two decades show that Black students were more likely than non-Black students to receive harsher punishments, to be streamed into academic tracks that excluded post-secondary access, and to drop out of school.

Youth criminal justice system data also suggest greater inequity for racialized young people. For example, Indigenous youth account for 50% of admissions to custodial facilities despite representing only 8% of Canadian youth. As well, Ontario police data show that Black youth are more likely to be charged and less likely to be only cautioned for minor offences than their non-Black counterparts.

For more information, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Racism affects both physical and mental health

As a determinant of health, racism has a profound impact on child well-being. Its many negative effects for racialized young people include:

  • restricted access to resources, such as housing, education and employment;
  • increased exposure to negative experiences, such as racist incidents and unnecessary contact with the criminal justice system;
  • increased engagement in unhealthy behaviours to cope with the stresses of racism, such as substance use; and
  • increased rates of physical injury as a result of violence.

To investigate the effects of racism on social and emotional well-being, researchers combined findings from more than 120 observational studies involving young people from
birth through age 18. Most of these studies were conducted in the United States, although
Canada and many other countries were also represented. Drawing on the experiences of
Black, Latinx, Asian and Indigenous children, the meta-analysis found many significant
links between racial discrimination and poorer well-being. Mental health concerns were
the most frequent, including depression, anxiety and conduct problems, as well as self-esteem and self-worth concerns.

Racism also has detrimental effects on children’s physical health. A study that included more than 95,000 American children aged 18 and younger found that those who experienced racial discrimination had a significantly lower likelihood of reporting that they were in excellent health, compared with those who did not have such experiences. As well, children exposed to racial discrimination were more likely to experience common childhood illnesses. The physical impact of racism also starts early, with low birth weights and preterm births being linked to maternal experiences of racial discrimination.

For more information, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Racism causes substantial damage

Race is a social construct used to classify individuals who share common features, such as skin colour. Because the concept does not reflect biology, parameters for classifying individuals or groups have changed over time, as have the words used to describe so-called races. Racism, in turn, occurs when people’s worth is assigned based on their identified race in ways that unfairly disadvantage some groups while simultaneously advantaging others.

Racism results in avoidable and unfair disparities in power, resources and opportunities — for individuals and groups and within institutions and social systems. And, both children and adults feel the impact of racism. Adults, however, hold the responsibility for working to eradicate racism and the damages it causes.

For more information, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Collaboration can help advance children’s wellbeing

Canada needs to substantially increase public investments in effective interventions to improve the mental health of children.

That was one of the key messages from a June 19/23 talk by Christine Schwartz, psychologist, SFU adjunct professor and Children’s Health Policy Centre scientific writer.

She was speaking to policy-makers, practitioners and researchers at a talk sponsored by the Children’s Healthcare Canada network.

The 30-minute Zoom presentation, followed by a Q&A session, was part of the SPARK program, designed to showcase knowledge, evidence and expertise to spark conversations, ideas and action.

“Effective collaborations between researchers and policy-makers can play a tremendous role in advancing the wellbeing of children,” Schwartz told the group. Audience members were especially interested in learning how CHPC team members have been able to conduct research that is both academically rigorous and responsive to the needs of policy-makers.

Go here to see a recording of the presentation.

National Indigenous Peoples Day takes place June 21

June 21 marks National Indigenous Peoples Day in Canada — a day to recognize and celebrate the heritage and cultures of First Nations, Inuit and Métis Indigenous peoples. In cooperation with Indigenous organizations, the Government of Canada chose June 21, the summer solstice, for National Indigenous Peoples Day. For generations, many Indigenous peoples and communities have celebrated their culture and heritage on or near this day due to the significance of the summer solstice as the longest day of the year. While Indigenous children have experienced, and still experience, the negative legacy of colonialism, many of them remain resilient. A survey of nearly 5,000 First Nations youth in Canada found that more than half reported having very good or excellent mental health. For more information, see Vol. 12, No. 2, page 5 of the Children’s Mental Health Research Quarterly.

CHPC associate director celebrates new appointment

Children’s Health Policy Centre Associate Director Nicole Catherine has just been named an affiliate faulty member of The Human Early Learning Partnership (HELP) at the University of British Columbia.

Catherine also holds the Canada Research Chair Tier 2 in Child Health Equity and Policy and is an assistant professor in the Faculty of Health Sciences at Simon Fraser University.

“I am thrilled to join HELP as an affiliate faculty member,” she said in the announcement of the honour. 

In an April 27 talk to faculty, staff and trainees at HELP, Catherine said that early prevention of childhood adversities through research-policy-practitioner collaborations is one of her major motivators.

As the former scientific director of a public health randomized controlled trial known as the BC Healthy Connections Project, she told the group: “Our plans to examine the longer-term effectiveness and cost-effectiveness of an early intervention, across adolescence, will directly inform policymakers, those who need to act to help children flourish.”

Audience members said the retention protocol — developed prior to data collection — impressed them because it ensured sustained engagement with 739 unserved families across 2.5 years. Catherine said: “Families that are unfairly labelled difficult to reach, and therefore underserved by health care, still need to be reached.”

Catherine is now leading new work exploring how to adapt enhanced maternal-child health programs, such as Nurse-Family Partnership, for Indigenous children and mothers in BC.

June is Pride Month

Pride month, for the LGBTQ+ community and their families and friends, began with Pride marches in the 1970s in major cities across North America.

The event was sparked by 1969 police raids of the Stonewall Inn, a gay bar in Greenwich Village, New York. This raid, followed by riots, formed a watershed moment in the modern LGBTQ+ rights movement and became the impetus for organizing pride marches on a much larger public scale.

In the US, President Bill Clinton declared June “Gay & Lesbian Pride Month” in 1999, and Pride Week started to be celebrated in Canada in 1973. Here, it became a national LGBT rights event in several Canadian cities, including Vancouver, Toronto, Ottawa, Montreal, Saskatoon and Winnipeg.

Although Vancouver will hold its annual Pride parade on Aug. 6 this year, June is considered the International Pride Month. To learn more about supporting LGBTQ+ youth, Vol. 11 No. 2 of the Children’s Health Policy Centre Research Quarterly, provides a primer.

Take action for anxiety

June 10 is World Anxiety Day, also known as Action Anxiety Day. Because anxiety is the most common health disorder facing children, the Canadian Mental Health Association encourages everyone to ACT on this day.

ACT stands for Awareness, Colours and Treatment. To raise awareness, telling stories of anxiety and posting support to social media, can help reduce the stigma and make others more aware of the need for action. Wearing colours of blue and orange on anxiety day will help signal to others that you care about people who are facing anxiety. And insisting on treatment can help challenge governments to make treating anxiety a priority.

The Canadian Mental Health Association offers a toolkit for the day, and you can learn more about anxiety in two issues of the Children’s Mental Health Research Quarterly, vol. 10 no. 2 and vol. 10 no. 3.

‘Keep the focus on kids’ — Waddell

A Canadian South Asian lifestyle magazine based in Vancouver, DARPAN, recently interviewed Children’s Health Policy Centre director Charlotte Waddell.

The feature, called the Darpan 10, is directed at community and thought leaders, addressing them with 10 questions relating to their role. Here, for example, is one of the questions:

“As part of your education and work that you have done with children, can you share some insights that would help better the public education system as a whole?”

Waddell’s answer:

“A huge lesson for me, in thinking of the research and the young people I have cared for as a child and youth psychiatrist, is to address social disparities in our society. Again, I am considering adversities such as socioeconomic disadvantage, colonialism, and racism. These problems do not cause all childhood mental disorders. But they affect kids unequally.

“So some kids have to carry higher burdens than others, through no fault of their own. In turn, the stresses associated with kids having to take these extra burdens can translate into higher rates of certain mental disorders over time. So it would help to address these disparities, treat all kids well, and ensure adequate prevention and treatment services for mental health difficulties. In turn, it will help the public education system if more kids are flourishing.”

The entire interview can be seen here.

How practitioners and policy-makers can support children with PTSD

The results of a systematic review by the Children’s Health Policy Centre suggest five implications for practice and policy relating to posttraumatic stress disorder (PTSD):

  • Use cognitive behavioural therapy when treating childhood PTSD. Our review showed that CBT was effective for children who had experienced a variety of traumas, including multiple and complex traumas. As well, many children in these studies were experiencing concurrent mental health concerns, and this treatment was still effective for their PTSD.
  • Consider Eye Movement Desensitization and Reprocessing (EMDR) as a reasonable second choice. Although there is more evidence supporting CBT to treat childhood PTSD, EMDR showed promise for children exposed to a single trauma, based on one trial. That said, EMDR needs further rigorous evaluation.
  • Do not rely on medications to treat childhood PTSD. Based on this review, there are no medications that are effective in treating childhood PTSD. Instead, effective psychosocial treatments should be the mainstay.
  • Treat concurrent conditions using effective interventions. Some children with PTSD will have concurrent mental disorders. These children should be provided with effective treatments addressing all of their mental health concerns. (Information about effective treatments for 12 of the most common disorders is available from one of our reports.) https://childhealthpolicy.ca/preventing-and-treating-childhood-mental-disorders/
  • Be prepared for more children to present with PTSD during COVID-19. Recent estimates suggest that PTSD may greatly increase due to the pandemic as many children may experience the trauma of losing loved ones or witnessing loved ones being seriously affected. CBT should still be used when trauma stems from COVID-19.

No child should be exposed to the kinds of serious adverse experiences that can give rise to PTSD. Prevention of such experiences therefore remains the top priority. But when prevention has not been possible, CBT can help. For more information, see Vol. 15, No. 2 of the Children’s Mental Health Research Quarterly.