At-a-glance – The Child Maltreatment Surveillance Indicator Framework
Aimée Campeau, MA; Shazmeera Qadri, MPH; Farah Barakat, BA; Gabriela Williams, MSc; Wendy Hovdestad, PhD; Maaz Shahid, MScPH; Tanya Lary, MA
Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
Correspondence: Wendy Hovdestad, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9; Tel: 613-799-0921; Email: firstname.lastname@example.org
The federal health portfolio has conducted surveillance on child maltreatment as a public health issue since the 1990s. The Public Health Agency of Canada (PHAC) is now releasing the Child Maltreatment Indicator Framework, to take its place alongside other PHAC frameworks, such as the Suicide Surveillance Indicator Framework. Based on a scoping review of existing reviews and meta-analyses, this Framework, along with the online interactive data tool, presents child maltreatment outcome indicators and risk and protective factors at the individual, family, community and societal levels, disaggregated by sex, age and other sociodemographic variables. This Framework will function as a valuable resource pertaining to an issue that affects at least one in three Canadian adults.
Keywords: child maltreatment, physical abuse, exposure to intimate partner violence, neglect, emotional maltreatment, sexual abuse
- The Child Maltreatment Surveillance Indicator Framework complements other indicator frameworks released by the Public Health Agency of Canada and presents available data on child maltreatment outcomes and risk and protective factors at the individual, family, community and societal level.
- One-third (34.1%) of the Canadian population aged 15 years and older have experienced at least one type of childhood maltreatment.
- Physical abuse was experienced most often (27.4%), followed by exposure to intimate partner violence (10.6%) and sexual abuse (8.1%).
- Factors such as parental mental illness, substance use and past experience of family violence can put children at higher risk of child maltreatment.
Child maltreatment is a public health issue, causing both immediate and long-term physical and mental health effects.Footnote 1 Surveillance data are key to policy and program efforts to prevent and address child maltreatment. The Public Health Agency of Canada (PHAC) is responsible for national surveillance of child maltreatment, including physical abuse, exposure to intimate partner violence, neglect, emotional maltreatment and sexual abuse.Footnote 2 PHAC currently collects data about child maltreatment from administrative data from child welfare agencies, proxy informant surveys and self-report surveys.
The Child Maltreatment Surveillance Indicator Framework (CMSIF) gathers available data on child maltreatment outcomes as well as risk and protective factors at the individual, family, community and societal levels to support research and policy development. The CMSIF, which is being released in this issue of Health Promotion and Chronic Disease Prevention in Canada, serves as a complement to other indicator frameworks released by PHAC. These include the Suicide Surveillance Indicators (SSI), the Canadian Chronic Disease Indicators (CCDI), the Positive Mental Health Surveillance Indicator Framework (PMHSIF) and the Physical Activity, Sedentary Behaviour and Sleep (PASS) Indicator Framework.
The CMSIF was developed using a scoping review method.Footnote 3 Article searches prioritized systematic reviews, meta-analyses and literature reviews that examined risk and protective factors related to any type of child maltreatment. References from retrieved article reviews were reviewed for additional citations. Relevant articles published in English between 2004 and 2016 and reports from public health organizations (e.g. the World Health Organization) were consulted. An initial list of approximately 45 to 50 indicators was reduced through consultations with child maltreatment surveillance experts as well as with the Family Violence Initiative member departments to verify that the final list of indicators was relevant and actionable within a public health approach.
Data from the 2014 General Social Survey (GSS) indicate that more than one-third (34.1%) of the population aged 15 years and older have experienced at least one of the following types of childhood maltreatment: physical or sexual abuse by an adult and/or exposure to violence by parents or guardians (Table 1). Of the three types of childhood maltreatment, physical abuse was experienced most often (27.4%), followed by exposure to intimate partner violence (10.6%) and sexual abuse (8.1%).
Because of the familial context in which most child maltreatment occurs, risk and protective factors focused on parental and/or family characteristics rather than child characteristics. Factors such as parental mental illness, substance abuse and past experience of family violence can put children at higher risk of child maltreatment.
Childhood experiences are a key social determinant of health.Footnote 4 The CMSIF provides available evidence about contexts and risk and protective factors to help target strategies to prevent and address child maltreatment.
The CMSIF is an evergreen document; it will be reviewed periodically and updated as new data become available. An online interactive tool on the Government of Canada's Public Health InfoBase will provide breakdowns for the indicators by sex, age, province/territory, immigrant status.
The data gaps identified in the framework, particularly those at the community and societal level, are being addressed through active data development using surveys and administrative data.
Conflicts of interest
The authors have no conflicts of interest to declare.
Authors' contributions and statement
AC, SQ, GW, MS and WH were involved in the design and/or conceptualization of the work, as well as the acquisition, analysis or interpretation of the data. FB, WH and TL were involved in the interpretation of the data, as well as drafting and revising the paper.
The content and views expressed in this article are those of the authors and do not necessarily reflect those of the Government of Canada.
|Indicator group||Indicator Measure(s)||Latest Estimate||Data Source (Year)|
|Childhood maltreatmentFootnote a||% of the population aged 15+ years who report experiencing, before age 15 years, any of these three types of childhood violence: physical or sexual abuse by an adultFootnote b and/or exposure to violence by parents or guardians||34.1%||GSS-Victimization (2014)|
|% of the population aged 15+ years who report experiencing, before age 15 years, physical abuse by an adultFootnote b||27.4%||GSS-Victimization (2014)|
|% of the population aged 15+ years who report experiencing, before age 15 years, sexual abuse by an adultFootnote b||8.1%||GSS-Victimization (2014)|
|% of the population aged 15+ years who report experiencing, before age 15 years, exposure to violence by parents or guardians||10.6%||GSS-Victimization (2014)|
|Police-reported child maltreatment||Incidence of police-reported family violence against children aged 0-17 years||233 per 100 000 children||UCR (2016)|
|Out-of-home placement||% of children 14 years and under who are in foster care||0.5%||Census 2016|
|Injuries due to child maltreatment, ED||Proportion of ED presentations for injuries due to child maltreatment, of total eCHIRPP cases, population aged 0-17 years||146.5 per 100 000 ED cases||eCHIRPP (January 4, 2011 to June 6, 2018)|
|Homicides of children||Number of police-reported homicides of children aged 0-17 years by a family member, per year (% out of all homicides of children)||0.4 per 100 000 children (47.4%)||Homicide Survey (2007-2016)|
|Individual-Level Risk & Protective Factors (parent/caregiver)Footnote c|
|Past family violence||% of adults with childrenFootnote b at home who report experiencing, before age 16 years, any of these three types of childhood violence: physical abuse, sexual abuse and/or exposure to violence by parents/guardians in the home||48.1%||CCHS-Mental Health (2012)|
|% of adults with childrenFootnote b at home who report contact with a child protection organization before age 16 years, about difficulties at home||4.1%||CCHS-Mental Health (2012)|
|Mental illness||% of adults with childrenFootnote b at home with symptoms consistent with a mood and/or anxiety disorder in the past 12 months||5.7%||CCHS-Mental Health (2012)|
|Stress||% of adults with childrenFootnote b at home who report that most days are quite a bit or extremely stressful||27.2%||CCHS-Annual (2017)|
|Substance use||% of adults with childrenFootnote b at home who report consuming 5+ alcoholic drinks (4+ for females) on one occasion 12+ times in the past 12 months||19.3%||CCHS-Annual (2017)|
|% of adults with childrenFootnote b at home with symptoms of drug abuse/dependence, in the past 12 months||0.7%||CCHS-Mental Health (2012)|
|Social support||% of adults with childrenFootnote b at home who perceive a high level of social support||94.6%||CCHS-Mental Health (2012)|
|Resilience||In development - parental coping skills|
|Family-Level Risk & Protective Factors|
|Family relationships||% of parents/guardians of children aged 1-9 years who report characteristics associated with high family functioning||91.1%||SYC-PMK (2010-2011)|
|% of Grade 6-10 students who agree or strongly agree getting the emotional help and support they need from their family||64.8%||HBSC (2013-2014)|
|% of Grade 6-10 students who agree or strongly agree to having a lot of arguments with their parents||21.7%||HBSC (2013-2014)|
|Family stability||% of children aged 1-9 years who sometimes or often are exposed to adults or teenagers physically fighting, hitting or trying to hurt others in their home, as reported by the parent or guardianFootnote d||2.6%||SYC-Child (2010-2011)|
|In development - presence of a non-biological transient caregiver in the home (e.g. parent's partner)|
|Parenting||% of children aged 1-9 years who sometimes, often or always experience physical punishment as a form of discipline, as reported by the parent or guardianFootnote d||0.5%||SYC-Child (2010-2011)|
|In development - caregiver's low awareness of children's needs and/or developmental stages|
|Caregiver burden||% of adults with childrenFootnote b at home who report that caring for family is the main contributor of their day-to-day stress||18.1 %||CCHS-Annual (2016)|
|In development - special needs of a child that may increase caregiver burden|
|Early childbearing||% of first-born live births to mothers under the age of 20 years||5.3%||CVSB (2015)|
|Household income||% of the population under the age of 18 years in economic families living below low-income cut-offs, after tax||7.4%||CINS (2016)|
|Community-Level Risk & Protective Factors|
|Services availability & accessibility||In development - community-based services for parents and families|
|Social environment||% of parents/guardians of children aged 1-9 years who are involved in volunteer organizations (school or church groups, community or ethnic associations)||33.9%||SYC-PMK (2010-2011)|
|In development - residential instability and/or neighbourhood impoverishment|
|Physical environment||In development - proximity to outlets that sell alcohol|
|Societal-Level Risk & Protective Factors|
|Healthy public policy||In development - formal support systems for families|
|Cultural & social norms||In development - social/cultural beliefs regarding physical punishment
as discipline for raising and educating children
|Inequality||In development - children's rights|
Abbreviations: CCHS-Annual, Canadian Community Health Survey - Annual Component; CCHS-Mental Health, Canadian Community Health Survey - Mental Health; CINS, Canadian Income Survey; CVSB, Canadian Vital Statistics - Birth Database (excluding Quebec); eCHIRPP, electronic Canadian Hospitals Injury Reporting and Prevention Program; ED, emergency department; GSS, General Social Survey; HBSC, Health Behaviour in School-aged Children; SYC-Child, Survey of Young Canadians - Child questionnaire; SYC-PMK, Survey of Young Canadians - Person Most Knowledgeable questionnaire; UCR, Uniform Crime Reporting Survey.
Note: "In development" refers to measures where their data source is currently not available or where more research is needed to identify a promising measure and data source.
- Footnote 1
World Health Organization. Child maltreatment: key facts [Internet]. Geneva (CH): World Health Organization; 2016 [cited 2019 Sep 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/child-maltreatment
- Footnote 2
Public Health Agency of Canada. Child maltreatment in Canada [Internet]. Ottawa (ON): Public Health Agency of Canada; 2012 [modified 2012 Jul 26; cited 2019 Sep 10]. Available from: http://www.phac-aspc.gc.ca/sfv-avf/sources/nfnts/nfnts-2006-maltr/index-eng.php
- Footnote 3
Ganann R, Ciliska D, Thomas H. Expediting systematic reviews: methods and implications of rapid reviews. Implement Sci. 2010;5:56-66. doi:10.1186/1748-5908-5-56.
- Footnote 4
Public Health Agency of Canada. Social determinants of health and health inequalities [Internet]. Ottawa (ON): Government of Canada; 2018 [modified 2019 Jun 28; cited 2019 Sep 10]. Available from:https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
- Footnote 5
Statistics Canada. Family violence in Canada: a statistical profile, 2015. Ottawa (ON): Statistics Canada; [modified 2017 May 4; cited 2019 Sep 10]. [Statistics Canada, Catalogue No.: 85-002-X].
- Footnote 6
Walsh CA, MacMillan HL, Trocmé N, Jamieson E, Boyle MH. Measurement of victimization in adolescents: development and validation of the Childhood Experiences of Violence Questionnaire. Child Abuse Negl. 2008;32(11):1037-57.
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