Doctrinal legal review
Doctrinal legal research can involve a literature review but also requires a trained expert in legal doctrine to read and analyse the primary sources of law [11]. Our analysis of the law was necessarily focused on legislation as a primary source, since child protection is regulated by legislation rather than case law. Any judicial decisions about the legislation would have added little useful information. An initial scan of the legislative history and framework in each province was undertaken by identifying secondary source coverage of child protection legislation in legal and social science databases [7, 12,13,14]. Then, the actual legislation for each province was reviewed, using electronic legislation databases and orthodox legal analysis using principles of statutory interpretation. Because electronic databases do not contain records of legislation from the 1960s, a hand search was carried out in August 2016 in a specialized law library for hard copies of legislation for each province. This strategy enabled identification of the relevant legislation.
Analysis of multiple provisions in each piece of legislation then enabled identification of the mandatory reporting duty and its wording and scope, the definition of key concepts such as “abuse”, “neglect” and “child in need of protection,” and the commencement date of the legislation. That is, multiple relevant parts of each statute were analyzed to identify the discrete provisions in each that detail the reporting duty, and associated provisions which define relevant terms which further establish and elucidate the nature and scope of the duty. In a number of cases, it was not possible to definitively identify subsequent amending legislation and its precise commencement date, although this generally applied to jurisdictions with small populations (i.e., Newfoundland and Labrador, Prince Edward Island). Where this occurred, triangulation of the analysis with conclusions drawn from secondary sources was used to confirm the interpretation.
It is noteworthy that legal provisions are often ambiguous, and while reporting laws were generally unequivocal, questions arose for some jurisdictions about whether the reporting duty applied to CSA. In such instances, conventional technical principles of statutory interpretation were applied to draw conclusions, based on the legislation’s text, context, and purpose.Footnote 1
CCHS data set and analysis
CCHS data
The 2012 CCHS-MH [15] was used to address the question of whether the enactment of laws requiring mandatory reporting of CM was associated with changes in the likelihood of CPO involvement in cases of CM. The CCHS-MH was developed by Statistics Canada in collaboration with Health Canada, the Public Health Agency of Canada, provincial health ministries, an expert advisory group, and academic experts.
The target population for the 2012 CCHS-MH comprised household residents aged 15 or older living in the 10 Canadian provinces. Excluded from the survey’s coverage were persons living on reserves and other Aboriginal settlements, full-time members of the Canadian Forces and the institutionalized population. Due to the nature of the questions asked in the CCHS-MH, proxy responses were not permitted making it necessary to exclude the institutionalized population. There are complexities regarding obtaining permission to conduct in-person interviews on military sites and reserves and therefore people living in these jurisdictions were excluded. Another reason to exclude the Canadian Forces is that they have a distinct health system and a separate health survey. Altogether, these exclusions represent about 3% of the target population. The response rate was 68.9%, yielding a sample of 25,113 individuals aged 15 or older [15]. This analysis is based on the “share” file (n = 23,709; 94%), a subset of the sample consisting of the records of respondents who agreed that their information could be shared with Statistics Canada’s partners. The majority of interviews (87%) were conducted in person using computer assisted interviewing.
Inclusion and exclusion criteria
The questions on CM were asked of respondents aged 18 or older (n = 22,486). Immigrants to Canada were excluded from the analysis (since it was not determined if CM occurred before or after immigration to Canada), reducing the sample size for this study to 18,561. Non-response to the individual questions on CM ranged from 0.9 to 1.2%; non-response to the item on contact with a CPO was 0.3%.
Informed consent
Respondents were informed about privacy, confidentiality and voluntary participation for the survey and provided informed consent prior to their participation [16].
Measures
CM variables
The occurrence of CPA, CSA and CEIPV was assessed by asking respondents about specific experiences (“things that may have happened to you before you were 16 in your school, in your neighbourhood, or in your family”) (Fig. 1). The source of the items for CPA and CEIPV is the Childhood Experiences of Violence Questionnaire (CEVQ) [17]. The CSA items are very similar to those used in the 2009 General Social Survey [18]. For each type of abuse, binary variables (yes/no) were created following CEVQ guidelines [17]. Contact with a child protection organization (CPO) was determined with the question, “Before age 16, did you ever see or talk to anyone from a child protection organization about difficulties at home?”
Socio-demographic variables
The socio-demographic characteristics used as controls in logistic regression models included, sex, respondent’s highest level of education (less than secondary graduation, secondary graduation, some postsecondary, postsecondary graduation), household income (quintiles based on household income adjusted by Statistics Canada’s low income cutoffs (LICO) specific to the number of individuals in the household, the size of the community, and the survey year), ethnicity (White, non-White) and province of residence at the time of the survey.
Analysis
Among individuals reporting CM, cross-tabulations were used to examine associations between year of birth and reporting contact with a CPO. Cohorts based on year of birth were established to examine any difference in the percentage of people reporting contact with a CPO before and after 1965—the year mandatory reporting was first implemented in Canada (in the province of Ontario). The following detailed birth cohorts were defined by year of birth:
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1939 or earlier (age > = 26 years in 1965)
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1940–1949 (age 16–25 years in 1965)
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1950–1957 (age 8–15 years in 1965)
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1958–1965 (age 0–7 years in 1965)
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1966–1974 (born 1–9 years after 1965 legislation)
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1975–1984 (born 10–19 years after 1965 legislation)
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1985–1994 (born 20–29 years after 1965 legislation)
In people reporting any type of CM within each of these detailed birth cohorts, the percentage reporting contact with a CPO was estimated. We also examined percentages reporting CPO contact for specific types of CM but sample sizes were too small and therefore, to enlarge the cell sizes and thereby increase the stability of CM-specific estimates, the birth cohorts were more broadly defined. These analyses focused on CPO contact rates among respondents born after 1965 (when mandatory reporting was introduced in Canada), but before or during the year mandatory reporting was implemented in the respondent’s province of residence at the time of the survey. The broad birth cohorts derived for estimates pertaining to specific types of CM were:
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born before or during 1965
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born after 1965, but before or during the year mandatory reporting was implemented in current province of residence
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born after the year mandatory reporting was implemented in current province of residence.
For this broader categorization, cross-tabulations and logistic regression (controlling for selected socio-demographic characteristics) were used to examine associations between year of birth and contact with a CPO among people reporting specific types of CM, as well as frequency and severity of CM.
Analyses were conducted using SAS Enterprise Guide 5.1. All estimates were based on weighted data. Weights were created at Statistics Canada so that the data would be representative of the Canadian population living in the ten provinces in 2012 and were adjusted to compensate for non-response. Variance estimates and 95% confidence intervals (CIs) were calculated using the bootstrap technique (with the SAS “proc survey” procedures) to account for the complex survey design of the CCHS-MH [15].