Search

Nous avons utilisé les données des cycles de 2020 et de 2021 de l’Enquête sur la COVID-19 et la santé mentale pour étudier les idées suicidaires chez les adultes de 18 à 34 ans au Canada. La prévalence des idées suicidaires chez les adultes de 18 à 34 ans était de 4,2 % à l’automne 2020 et de 8,0 % au printemps 2021. C’est le sous-groupe des adultes de 18 à 24 ans qui a connu la prévalence la plus élevée, avec 10,7 % au printemps 2021. La prévalence variait en fonction des caractéristiques sociodémographiques et tendait à être plus élevée chez les personnes vivant dans un milieu défavorisé sur le plan matériel. Les idées suicidaires se sont révélées fortement associées aux facteurs de stress liés à la pandémie subis par les répondants.

Introduction D’après de récentes données probantes, il y aurait eu une augmentation des idées suicidaires au cours de la pandémie de COVID-19. Notre recherche visait à estimer la probabilité de la présence d’idées suicidaires chez les adultes du Canada ayant subi des répercussions de la pandémie et à caractériser l’évolution de cette probabilité tout au long de la pandémie. Méthodologie Nous avons analysé les données regroupées issues des deux cycles de l’Enquête sur la COVID-19 et la santé mentale, à laquelle ont participé 18 936 adultes de 18 ans et plus, qui ont répondu aux questions du 11 septembre au 4 décembre 2020 puis du 1er février au 7 mai 2021. Nous avons estimé la prévalence des idées suicidaires depuis le début de la pandémie puis nous avons évalué, par régression logistique, la probabilité d’idées suicidaires chez les adultes ayant subi des répercussions de la pandémie, en fonction de facteurs de risque sociaux, de l’état mental général, d’indicateurs de bonne santé mentale et des stratégies d’adaptation. Résultats Les adultes ayant eu des expériences négatives liées à la pandémie présentaient un risque significativement plus élevé d’avoir des idées suicidaires, avec une relation dose-réponse manifeste. Les personnes ayant augmenté leur consommation d’alcool ou de cannabis, se disant inquiètes de la violence à la maison ou présentant des symptômes modérés à graves de dépression, d’anxiété ou de trouble stress post-traumatique avaient également un risque significativement plus élevé d’idées suicidaires. Le risque était significativement plus faible chez les personnes se percevant comme ayant une bonne santé mentale ou ayant fait état d’un fort sentiment d’appartenance à leur communauté ou d’une grande satisfaction à l’égard de la vie, qui faisaient de l’exercice pour se maintenir en bonne santé mentale ou physique ou qui s’adonnaient régulièrement à un passe-temps. Conclusion La pandémie de COVID-19 a une influence sur les idées suicidaires au Canada. Les données probantes de notre étude pourront servir à mettre au point des interventions sanitaires ciblées en vue de la prévention du suicide.

Introduction Recent evidence has suggested that there has been an increase in suicidal ideation during the COVID-19 pandemic. Our objectives were to estimate the likelihood of suicidal ideation among adults in Canada who experienced pandemic-related impacts and to determine if this likelihood changed during the pandemic. Methods We analyzed pooled data for 18 936 adults 18 years or older from two cycles of the Survey on COVID-19 and Mental Health collected from 11 September to 4 December 2020 and from 1 February to 7 May 2021. We estimated the prevalence of suicidal ideation since the pandemic began and conducted logistic regression to evaluate the likelihood of suicidal ideation by adults who experienced pandemic-related impacts, and by factors related to social risk, mental health status, positive mental health indicators and coping strategies. Results Adults who had adverse pandemic-related experiences were significantly more likely to experience suicidal ideation; a dose–response relationship was evident. People who increased their alcohol or cannabis use, expressed concerns about violence in their home or who had moderate to severe symptoms of depression, anxiety or posttraumatic stress disorder also had significantly higher risk of suicidal ideation. The risk was significantly lower among people who reported high self-rated mental health, community belonging or life satisfaction, who exercised for their mental and/or physical health or who pursued hobbies. Conclusion The COVID-19 pandemic has influenced suicidal ideation in Canada. Our study provides evidence for targeted public health interventions related to suicide prevention.

Objectives Adolescent vaping has become a public health concern. The aim of this study was to examine the associations between adolescent vaping and subsequent use of other substances and risk factors for polysubstance use. Methods The Well-being and Experiences Study is a longitudinal, intergenerational study conducted in Manitoba, Canada. The sample for this study consisted of adolescents and emerging adults who participated in Waves 1 (N = 1,002; 2017-18; aged 14–17 years) and 2 (n = 756; 2019; aged 15–20 years). Multinomial logistic regression analysis was performed. Results Adolescent vaping was associated with continued use of alcohol, cannabis, and cigarettes (adjusted relative risk ratio [aRRR] range: 12.92–19.39), new onset use of cannabis (aRRR: 6.04) and cigarettes (aRRR: 3.66), and concurrent and simultaneous polysubstance use (aRRR range: 3.14–24.25). Several risk factors were identified for concurrently using three or four substances in the past year (aRRR range: 1.76–2.86) and simultaneously using alcohol, cannabis, and nicotine (aRRR range: 1.99–3.11). Among those who reported vaping nicotine at Wave 2, 33.6% of males and 24.2% of females reported doing so as a coping mechanism. Conclusions Adolescent vaping is a risk factor for subsequent use of other substances and polysubstance use. Efforts are needed to prevent vaping initiation and help adolescents with cessation. Strategies should include selective interventions for those with histories of childhood adversity and mental health disorder.

The COVID-19 pandemic has had major economic, social and psychological consequences for adolescents and young adults. It is unclear whether those with a history of adverse childhood experiences (ACEs) were particularly vulnerable. We examined whether a history of ACEs was associated with financial difficulties, lack of emotional support, feeling stressed/anxious, feeling down/depressed, increased alcohol and/or cannabis use and increased conflict with parents, siblings and/or intimate partners among 16- to 21-year-olds during the pandemic.Data were collected in November and December 2020 from respondents aged 16 to 21 years (n = 664) participating in the longitudinal and intergenerational Well-being and Experiences Study (Wave 3) conducted in Manitoba, Canada. Age-stratified associations between ACEs and pandemic-related stressors/symptoms were examined with binary and multinomial logistic regression.A history of ACEs was associated with pandemic-related financial difficulties (adjusted relative risk ratio [aRRR] range: 2.44-7.55); lack of emotional support (aRRR range: 2.13-26.77); higher levels of feeling stressed/anxious and down/depressed (adjusted odds ratio [aOR] range: 1.78-5.05); increased alcohol and cannabis use (aOR range: 1.99-8.02); and increased relationship conflict (aOR range: 1.98-22.59). Fewer associations emerged for older adolescents and these were not to the same degree as for young adults.Adolescents and young adults with a history of ACEs reported increased odds of pandemic-related stressors and symptoms, and may need more resources and greater support compared to peers without an ACE history. Differences in results for adolescents and young adults suggest that interventions should be tailored to the needs of each age group.La pandémie de COVID-19 a eu d’importantes conséquences économiques, sociales et psychologiques pour les adolescents et les jeunes adultes, sans que l’on sache si ceux ayant des antécédents d’expériences négatives dans l’enfance (ENE) étaient particulièrement vulnérables. Nous avons donc vérifié si des antécédents d’ENE étaient associés chez les jeunes de 16 à 21 ans, pendant la pandémie, à des difficultés financières, à un manque de soutien psychologique, à un sentiment de stress ou d’anxiété, à une baisse de moral ou une dépression, à une consommation accrue d’alcool ou de cannabis et à une hausse des conflits avec les parents, la fratrie ou les partenaires intimes.Les données ont été recueillies en novembre et décembre 2020 auprès de répondants âgés de 16 à 21 ans (n = 664) participant au cycle 3 de l’étude longitudinale et intergénérationnelle WES (Well-being and Experience Study), menée au Manitoba (Canada). Les associations, stratifiées par âge, entre les ENE et les facteurs de stress ou symptômes liés à la pandémie ont été analysées par régression logistique binaire et multinomiale.Les antécédents d’ENE sont associés aux facteurs liés à la pandémie suivants : difficultés financières (plage du rapport de risque relatif ajusté [RRRa] : 2,44 à 7,55), manque de soutien psychologique (plage du RRRa : 2,13 à 26,77), niveau accru de stress ou d’anxiété et de baisse de moral ou dépression (plage du rapport de cotes ajusté [RCa] : 1,78 à 5,05), consommation accrue d’alcool et de cannabis (plage du RCa : 1,99 à 8,02) et hausse des conflits relationnels (plage du RCa : 1,98 à 22,59). Les grands adolescents ont présenté un moins grand nombre d’associations et d’ampleur plus faible que les jeunes adultes.Les adolescents et les jeunes adultes ayant des antécédents d’ENE ont fait état d’une probabilité accrue de facteurs de stress et de symptômes liés à la pandémie. Ils pourraient donc avoir besoin de plus de ressources et de soutien que leurs pairs sans antécédents d’ENE. Les différences entre les résultats des adolescents et ceux des jeunes adultes indiquent que les interventions devraient être adaptées aux besoins de chaque groupe d’âge.The COVID-19 pandemic has exacerbated financial, social and psychological difficulties for young people. Older adolescents and young adults with a history of adverse childhood experiences (ACEs) were more vulnerable to pandemic-related stressors and symptoms compared to their peers without an ACEs history. Young adults with a history of ACEs may need additional resources that provide financial assistance, address mental health concerns, foster emotional support, reduce substance use and facilitate positive relationships. Older adolescents with a history of ACEs may benefit from interventions that improve feelings of depression and foster emotional support and healthy relationships with parents. Psychological first aid that provides practical and emotional support may be a suitable approach for supporting recovery from the pandemic.La pandémie de COVID-19 a exacerbé les difficultés financières, sociales et psychologiques des jeunes. Les grands adolescents et les jeunes adultes ayant des antécédents d’ENE étaient plus vulnérables aux facteurs de stress et aux symptômes liés à la pandémie que leurs pairs sans antécédents d’ENE. Les jeunes adultes ayant des antécédents d’ENE pourraient avoir besoin de ressources supplémentaires pour leur fournir de l’aide financière, traiter les problèmes de santé mentale, favoriser le soutien psychologique, réduire la toxicomanie et faciliter les relations positives. Les grands adolescents ayant des antécédents d’ENE pourraient bénéficier d’interventions améliorant les sentiments dépressifs et favorisant le soutien psychologique ainsi que les relations saines avec les parents. Des premiers soins psychologiques offrant un soutien pratique et psychologique semblent constituer une première approche appropriée pour soutenir le rétablissement après la pandémie.

Since the outbreak of COVID-19, numerous studies from around the world have reported declines in mental health. However, most of these studies were of low-to-moderate quality and many were based on convenience samples or used mental health measures with low validity, or both. Consequently, it has been difficult to draw conclusions.Both the 2020 Survey on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015-2019) used the Patient Health Questionnaire-9 to screen for major depressive disorder (MDD) in adults aged 18 or older. The prevalence of MDD was compared between the SCMH and the CCHS. Risk and protective factors for MDD in the SCMH were examined using bivariate and logistic regression analyses.Based on SCMH data, 15.2% (95% CI: 14.2-16.2) of Canadians screened positive for MDD. The prevalence of MDD was more than two times higher in the SCMH (during COVID-19) than in the CCHS (predating COVID-19). In bivariate analysis, Canadians reporting five or more COVID-19-related risk factors were close to 30 times more likely to have MDD than those reporting no risk factors. Mastery and a sense of community belonging were protective factors for MDD.After remaining stable for two decades, the prevalence of depression among Canadians increased substantially with the onset of COVID-19. Ongoing monitoring of this common condition associated with major morbidity is vital to determine if elevated levels of MDD persist as we progress through and beyond future waves of COVID-19.Depuis le début de la pandémie de COVID 19, de nombreuses études à l’échelle mondiale ont fait état d’une détérioration de la santé mentale. Toutefois, la plupart de ces études sont de qualité faible ou moyenne, et bon nombre d’entre elles s’appuient sur des échantillons de commodité ou utilisent des mesures de la santé mentale à faible validité, voire les deux. Par conséquent, il est difficile d’en tirer des conclusions.L’Enquête sur la COVID 19 et la santé mentale (ECSM) de 2020 et l’Enquête sur la santé dans les collectivités canadiennes (ESCC) (2015-2019) ont toutes les deux utilisé le Questionnaire en 9 points sur la santé du patient pour dépister le trouble dépressif majeur (TDM) chez les adultes de 18 ans et plus. On a comparé la prévalence du TDM dans l’ECSM et dans l’ESCC. Dans l’ECSM, on a étudié les facteurs de risque de TDM et les facteurs de protection par analyses bivariées à l’aide de régressions logistiques.Selon les données de l’ECSM, 15,2 % (IC à 95 % : 14,2 à 16,2 %) des Canadiens ont obtenu un résultat positif au dépistage du TDM. La prévalence du TDM était plus de deux fois plus élevée dans l’ECSM (durant la COVID 19) que dans l’ESCC (avant la COVID 19). Dans l’analyse bivariée, les Canadiens ayant déclaré avoir au moins cinq facteurs de risque liés à la COVID 19 étaient environ 30 fois plus susceptibles d’avoir un TDM que ceux ayant déclaré n’avoir aucun facteur de risque. Le sentiment de maîtrise et le sentiment d’appartenance à la communauté se sont révélés des facteurs de protection contre le TDM.Après être demeurée stable pendant 20 ans, la prévalence de la dépression chez les Canadiens a considérablement augmenté depuis le début de la pandémie de COVID 19. Il est essentiel de surveiller de façon continue ce trouble courant qui est associé à une morbidité importante, afin de déterminer si les taux élevés de TDM vont persister pendant et après les différentes vagues de COVID 19.During the second wave of COVID-19 in the fall of 2020, the prevalence of major depressive disorder (MDD) among Canadians aged 18 or older (defined as the proportion screening positive for MDD using the Patient Health Questionnaire-9) was 15% (13% for males and 18% for females). Based on data from eight Canadian provinces, the prevalence of MDD during the fall of 2020 was more than double what it had been in pre-COVID times (16% vs. 7%). A dose-response relationship was observed between MDD and COVID-19-related risk factors for poor mental health. Each increase in the number of COVID-19-related risk factors was associated with an increase the prevalence of MDD, ranging from 2% among those reporting no risk factors to 62% among those reporting five or more risk factors. Mastery, the extent to which individuals perceive they have control over their life circumstances, was strongly associated with MDD. Those with low levels of mastery were 17 times more likely to screen positive for MDD than those with high mastery. Individuals reporting a very weak sense of community belonging were 10 times more likely to screen positive for MDD than those with a very strong sense of belonging.Au cours de la deuxième vague de COVID 19 à l’automne 2020, la prévalence du trouble dépressif majeur (TDM), défini comme la proportion des répondants ayant un résultat positif au dépistage du TDM à l’aide du questionnaire sur la santé du patient (PHQ-9) chez les Canadiens de 18 ans et plus, était de 15 % (13 % chez les hommes et 18 % chez les femmes). D’après les données de huit provinces canadiennes, la prévalence du TDM à l’automne 2020 avait plus que doublé par rapport à la prévalence observée avant la pandémie de COVID (16 % contre 7 %). Une relation dose réponse a été observée entre le TDM et les facteurs de risque liés à la COVID 19 susceptibles d’entraîner une mauvaise santé mentale. Il est à noter que plus le nombre de facteurs de risque liés à la COVID 19 augmente, plus la prévalence du TDM augmente : ainsi, la prévalence du TDM passe de 2 % chez les personnes ne déclarant aucun facteur de risque lié à la COVID 19 à 62 % chez les personnes déclarant avoir cinq facteurs de risque ou plus. Le sentiment de maîtrise, c’est à dire la mesure dans laquelle une personne a l’impression d’exercer un contrôle sur ses conditions de vie, est fortement associé au TDM. Les personnes ayant l’impression d’avoir peu de maîtrise sur leur vie étaient 17 fois plus susceptibles d’obtenir un résultat positif au dépistage du TDM que celles ayant un fort sentiment de maîtrise de leur vie. Par ailleurs, les personnes déclarant avoir un très faible sentiment d’appartenance à la communauté étaient 10 fois plus susceptibles d’obtenir un résultat positif au dépistage du TDM que celles ayant un très fort sentiment d’appartenance.

Introduction La pandémie de COVID-19 a eu d’importantes conséquences économiques, sociales et psychologiques pour les adolescents et les jeunes adultes, sans que l’on sache si ceux ayant des antécédents d’expériences négatives dans l’enfance (ENE) étaient particulièrement vulnérables. Nous avons donc vérifié si des antécédents d’ENE étaient associés chez les jeunes de 16 à 21 ans, pendant la pandémie, à des difficultés financières, à un manque de soutien psychologique, à un sentiment de stress ou d’anxiété, à une baisse de moral ou une dépression, à une consommation accrue d’alcool ou de cannabis et à une hausse des conflits avec les parents, la fratrie ou les partenaires intimes. Méthodologie Les données ont été recueillies en novembre et décembre 2020 auprès de répondants âgés de 16 à 21 ans (n = 664) participant au cycle 3 de l’étude longitudinale et intergénérationnelle WES (Well-being and Experience Study), menée au Manitoba (Canada). Les associations, stratifiées par âge, entre les ENE et les facteurs de stress ou symptômes liés à la pandémie ont été analysées par régression logistique binaire et multinomiale. Résultats Les antécédents d’ENE sont associés aux facteurs liés à la pandémie suivants : difficultés financières (plage du rapport de risque relatif ajusté [RRRa] : 2,44 à 7,55), manque de soutien psychologique (plage du RRRa : 2,13 à 26,77), niveau accru de stress ou d’anxiété et de baisse de moral ou dépression (plage du rapport de cotes ajusté [RCa] : 1,78 à 5,05), consommation accrue d’alcool et de cannabis (plage du RCa : 1,99 à 8,02) et hausse des conflits relationnels (plage du RCa : 1,98 à 22,59). Les grands adolescents ont présenté un moins grand nombre d’associations et d’ampleur plus faible que les jeunes adultes. Conclusion Les adolescents et les jeunes adultes ayant des antécédents d’ENE ont fait état d’une probabilité accrue de facteurs de stress et de symptômes liés à la pandémie. Ils pourraient donc avoir besoin de plus de ressources et de soutien que leurs pairs sans antécédents d’ENE. Les différences entre les résultats des adolescents et ceux des jeunes adultes indiquent que les interventions devraient être adaptées aux besoins de chaque groupe d’âge.

BACKGROUND: Ongoing surveillance of the means of suicide is necessary for effective prevention. We examined how mortality rates owing to different means of suicide changed in Canada from 1981 to 2018. METHODS: We obtained data from 1981 to 2018 on suicide deaths of individuals aged 10 years and older, from the Canadian Vital Statistics Death Database. We used joinpoint regression analysis to examine changes over time in the suicide mortality rate for the 3 most common means of suicide. RESULTS: The age-standardized suicide mortality rate declined in earlier decades for both sexes, but did not significantly change in recent decades for either sex. The age-standardized rate of suicide by suffocation increased from 1993 for females (2.1% per year) and from 1996 for males (0.4% per year). The age-standardized rate of suicide by poisoning decreased for females (2.2% per year) and males (2.1% per year) from 1981 to 2018. The age-standardized rate of suicide by firearm decreased from 1981 to 2008 (7.4% per year) but did not significantly change there-after for females; for males, it decreased 2.1% per year from 1981 to 1993 and 5.7% per year from 1993 to 2007, but did not significantly change thereafter. INTERPRETATION: For both sexes, the rate of suicide by poisoning is decreasing, the rate of suicide by suffocation is increasing, and the rate of suicide by firearm has not significantly changed in the last decade. Given the high proportion of suicide deaths by suffocation, its increasing rate and the difficulty of restricting the means of suffocation, other approaches to suicide prevention are needed.

Background Population-level prevalence estimates for a broad range of adverse childhood experiences (ACEs), which are known to affect health across the lifespan, are currently unavailable in Canada. The purpose of this study was to estimate the prevalence of individual ACEs by sociodemographic factors among middle-aged and older adults. Methods Data for this cross-sectional analysis were obtained from the first follow-up (2015-2018) of the Canadian Longitudinal Study on Aging (baseline recruitment from 2011 to 2015). Participants included individuals aged 45-85 years and residing in the community in the 10 Canadian provinces. Exposure to ACEs was assessed using a retrospective, self-report questionnaire. Logistic regression was used to obtain the adjusted prevalence estimates of ACEs within groups formed by the sociodemographic characteristics and each variable was adjusted for all other sociodemographic variables. Results Of the 44 817 participants in the first follow-up, 61.6% (weighted) reported exposure to at least 1 ACE. Exposure to physical abuse (weighted prevalence of 25.7%), intimate partner violence (22.4%) and emotional abuse (21.8%) were the most prevalent types of ACEs. Individuals younger than 65 years (born in 1950-1969), with no postsecondary education or education below a bachelor's degree, or with annual household income less than $20 000 reported greater exposure to ACEs. Reporting for many ACEs was higher among women and those of nonheterosexual orientation. Overall, British Columbia, Alberta, Manitoba, Ontario and Quebec reported relatively higher prevalence for several examined categories of ACEs. Interpretation Adverse childhood experiences were highly prevalent across all demographic groups with substantial heterogeneity in the distribution among the middle and older age population. The high prevalence of ACEs and their potential negative consequences on health and well-being emphasize the need to develop and promote trauma-informed care to assist individuals affected by ACEs.

Data from the first round of the nationally representative Survey on COVID-19 and Mental Health (SCMH) revealed that the prevalence of recent suicidal ideation in the fall of 2020 in Canada did not differ significantly from that in the pre-pandemic period in 2019. The objective of the present study was to reassess the prevalence of recent suicidal ideation in the spring of 2021.The prevalence of suicidal ideation among adults in Canada was examined using the 2021 SCMH (conducted between February 1 and May 7, 2021), and it was compared with the prevalence in the 2019 Canadian Community Health Survey. Unadjusted logistic regression analysis was used to assess the differential likelihood of reporting suicidal ideation in population subgroups.Among adults in Canada, the prevalence of suicidal ideation since the pandemic began was 4.2%, which was significantly higher than the pre-pandemic prevalence of 2.7% in 2019. A statistically significant increase in prevalence was observed among females and males, age groups younger than 65, and several other sociodemographic groups, as well as in British Columbia, the Prairie provinces and Ontario. People who were younger than 65 years, were born in Canada, had lower educational attainment, or were never married were significantly more likely to report suicidal ideation than others during the pandemic.As the second year of the pandemic began, the prevalence of recent suicidal ideation in Canada was higher than it had been before the pandemic in 2019. Continuous monitoring of suicide-related outcomes and risks is necessary so that population-level changes can be detected and inform public health action.

Evidence about how the pandemic affected household violence in Canada is mixed, but inarguably, the risk factors increased. This study used data from the 2020 Canadian Perspective Survey Series and the 2020 and 2021 Surveys of COVID-19 and Mental Health to examine the following: changes in the prevalence of concern about violence in individuals’ own homes during the pandemic; the characteristics of those who expressed concern; and the prevalence of concerns for specific household members. Among Canadians, the prevalence of concern about violence in individuals’ own homes decreased significantly between July and Fall 2020 (5.8% to 4.2%). Among women, the characteristics that were significantly associated with higher adjusted odds of concern about household violence included larger household size and lower household income. Lower education among women was associated with lower adjusted odds of concern. The associations with higher adjusted odds of concern among men included: being an immigrant, larger household size, and lower household income. From Fall 2020 to Spring 2021, the prevalence of concerns for oneself and for a child/children increased (1.7% to 2.5% and 1.0% to 2.5%, respectively), but concern for other adults in the household decreased (1.9% to 1.2%). Ongoing surveillance is needed to understand vulnerable populations’ exposure to household violence and to inform policies and programs.

ObjectivesIn this review we: (1) identify and describe nationally representative surveys with child maltreatment (CM) questions conducted by governments in low-income, middle-income and high-income countries and (2) describe procedures implemented to address respondents’ safety and minimise potential distress.DesignWe conducted a systematic search across eight databases from 1 January 2000 to 5 July 2021 to identify original studies with information about relevant surveys. Additional information about surveys was obtained through survey methods studies, survey reports, survey websites or by identifying full questionnaires (when available).ResultsForty-six studies representing 139 surveys (98 youth and 41 adult) conducted by governments from 105 countries were identified. Surveys implemented a variety of procedures to maximise the safety and/or reduce distress for respondents including providing the option to withdraw from the survey and/or securing confidentiality and privacy for the respondent. In many surveys, further steps were taken such as providing information for support services, providing sensitivity training to survey administrators when interviews were conducted, among others. A minority of surveys took additional steps to empirically assess potential distress experienced by respondents.ConclusionsAssessing risk and protective factors and developing effective interventions and policies are essential to reduce the burden of violence against children. While asking about experiences of CM requires careful consideration, procedures to maximise the safety and minimise potential distress to respondents have been successfully implemented globally, although practices differ across surveys. Further analysis is required to assist governments to implement the best possible safety protocols to protect respondents in future surveys.

Background The suicide rate in Canada decreased by 24% during the past four decades. However, rates vary between provinces and territories, and not all jurisdictions experienced the same changes. This study examined suicide rates over time in the province of Newfoundland and Labrador. Methods We used cross-sectional surveillance data from the Canadian Vital Statistics Death Database to examine suicide rates in Newfoundland and Labrador from 1981 to 2018. We calculated annual age-standardized suicide mortality rates and used joinpoint regression to estimate the average annual percent change (AAPC) in suicide rates overall and by sex, age group, and means of suicide. Results From 1981 to 2018, 1759 deaths by suicide were recorded among people in Newfoundland and Labrador. The age-standardized suicide mortality rate increased more than threefold over the study period, from 4.6 to 15.4 deaths per 100,000. The suicide rate was higher among males than females, and accounted for 83.1% of suicide deaths (n = 1462); the male-to-female ratio of suicide deaths was 4.9 to 1. The average annual percent change in suicide rates was higher among females than males (6.3% versus 2.0%). Age-specific suicide rates increased significantly for all age groups, except seniors (aged 65 or older); the largest increase was among youth aged 10 to 24 years old (AAPC 3.5; 95% CI, 1.6 to 5.5). The predominant means of suicide was hanging/strangulation/suffocation, which accounted for 43.8% of all deaths by suicide. Conclusions The suicide rate in Newfoundland and Labrador increased steadily between 1981 and 2018, which was in contrast to the national rate decline. The disparity between the provincial and national suicide rates and the variations by sex and age underscore the need for a public health approach to prevention that accounts for geographic and demographic differences in the epidemiology of suicide.

Most of the research on caregiver vulnerabilities associated with the perpetration of child maltreatment (CM) focuses on perpetrators of child physical or sexual abuse. Less is known about the association of specific caregiver vulnerabilities and the risk of other CM types or how these vulnerabilities are related to child harm. The aim of the study was to examine the association of caregiver’s vulnerabilities with types of substantiated CM and child physical and mental/emotional harm as a result of maltreatment. Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect collected in 2008 (CIS-2008). The CIS-2008 consisted of investigations of children aged 15 years and younger from 112 child welfare sites across Canada ( N = 15,980). Descriptive statistics and logistic regression were used to examine relationships between caregiver vulnerabilities and outcomes of interest. Caregiver vulnerabilities were prevalent among cases of CM substantiated by child welfare agencies across Canada. Low social support, domestic violence, mental health issues, and substance abuse problems were noted among a substantial proportion of abusive caregivers. Caregiver cognitive impairments and domestic violence perpetration were associated with increased odds of child physical harm, but only among children aged 0 to 4 years. Most individual types of caregiver vulnerabilities were associated with increased odds of child mental or emotional harm across all child age groups. Insight into caregiver vulnerabilities associated with the perpetration of CM may help inform intervention targets prior to a family’s involvement in the child welfare system.

OBJECTIVE To establish whether there is a relationship between the frequency and severity of different types of childhood maltreatment and adulthood arthritis. METHODS Analysis of the 2012 Canadian Community Health Survey-Mental Health included 21,889 respondents ages ≥18 years. Severity and frequency of childhood physical abuse (CPA), and childhood sexual abuse (CSA), and the frequency of childhood exposure to intimate partner violence (CEIPV) were assessed by asking about "things that may have happened to you before you were 16 in your school, in your neighborhood, or in your family." Respondents were also asked about chronic conditions diagnosed by a health professional, including arthritis. Covariates were sociodemographic characteristics, health risk variables (e.g., obesity), mental disorders, and a count of other chronic conditions. Multivariate logistic regression analysis was used to examine associations between childhood maltreatment and arthritis. RESULTS A total of 17.5% of respondents reported arthritis. A higher prevalence of arthritis was observed for those who had experienced severe and/or frequent childhood maltreatment (32% for CPA and 27% for both CSA and CEIPV). These relationships persisted after controlling for sociodemographic variables. After controlling for all covariates, arthritis remained independently associated with severe and/or frequent CPA (dose-response relationship) and frequent CEIPV. CONCLUSION We found that the greater the frequency and severity of childhood maltreatment, the greater the magnitude of association with arthritis. This might reflect the role of the enduring immune and metabolic abnormalities and chronic inflammation associated with childhood maltreatment in the etiopathogensis of osteoarthritis (OA) or be an indicator of the role of joint injury in causing OA.

Background Public health surveillance is essential to inform programs that aim to eradicate child maltreatment (CM) and to provide services to children and families. However, collection of CM data imposes a burden on child welfare workers (CWWs). This study assesses the feasibility of hiring coders to abstract the required information from administrative records and case narratives. Methods Based on a convenience sample of child welfare data from Manitoba, Canada, two coders abstracted information on 181 alleged CM cases. The coders completed a short web-based questionnaire for each case to identify which of five types of CM had been investigated, level of substantiation for each type, and risk of future CM. The CWWs responsible for each case completed the same questionnaire. Percentages of the occurrence of CM by the three sources were compared. The validity of the coders’ classifications was assessed by calculating sensitivity, specificity, and positive and negative predictive values, against the CWWs’ classifications as the “gold standard.” Cohen’s kappa was also calculated. Results The coders’ classifications of physical abuse, sexual abuse and neglect generally matched those of CWWs; for exposure to intimate partner violence, agreement was weak for one coder. Coding of emotional maltreatment and risk investigations could not be evaluated. Conclusion Results were promising. Abstraction was not time-consuming. Differences between coders and CWWs can be largely explained by the administrative data system, child welfare practice, and legislation. Further investigation is required to determine if additional training could improve coders’ classifications of CM.

Objective: To provide evidence of trends in child sexual abuse (CSA) in Canada. Methods: Using data from 15,801 males and 18,669 females who responded to the 2014 General Social Survey (GSS), we compared the prevalence of CSA by age cohorts. Age cohort patterns were examined for several sub-populations including males, females, Indigenous peoples, and people living in low-income households. Results: After an increase in the post-World War II period, there has been a decline in CSA in Canada since the early 1990s. Findings indicate a decline for both sexes; although, the evidence is more compelling for females. There is also evidence of a decline for Indigenous peoples, for those living in low-income households, and regardless of the relationship to the perpetrator (i.e., family member, a teacher/professor/tutor, a babysitter, a nanny, other non-family member but known to the respondent, or a stranger). Conclusions: In Canada, evidence from 3 retrospective population surveys suggests a decline in CSA since the early 1990s. However, given the associated harm, continued progress to the eradication of CSA is essential.

Children of girls and young women experiencing socioeconomic disadvantage are at risk of maltreatment and associated health and developmental problems. Nurse-Family Partnership (NFP) is an early intervention program designed to improve child and maternal health outcomes. The effectiveness of NFP is being evaluated in British Columbia (BC) through a randomized controlled trial, augmented by a process evaluation to identify influences on how NFP was implemented.To describe how public health nurses providing NFP perceived their interactions with child protection professionals.Forty-seven public health nurses across BC.The principles of interpretive description informed the qualitative component of the process evaluation. Data from interviews and focus groups were analyzed using the framework analysis approach. A thematic framework was generated through processes of coding, charting and mapping, with a focus on organizational and systems influences.Nurses' practice in supporting families often involved engagement with child protection services. Four themes about the nature of this work were identified: 1) developing a deeper understanding of the disciplinary perspectives of child protection, 2) striving for strengthened collaboration, 3) navigating change and uncertainty, and 4) responding to family and community complexity.Participants valued the contribution of child protection professionals and expressed willingness to collaborate to support families. However, collaboration was constrained by multiple structural barriers. Collaborative models offer possibilities for integrated practice, although can be difficult to implement within current health and child protection systems and child protection regulatory contexts.

Background Both childhood maltreatment (CM) and intimate partner violence (IPV) are public health problems that have been related to a wide range of adverse health consequences. However, studies examining associations between specific types of CM and experiencing IPV in adulthood have yielded conflicting results. Methods Using data from 10,608 men and 11,458 women aged 18 or older from Canada’s 2014 General Social Survey, we examined associations between three types of CM—childhood physical abuse (CPA), childhood sexual abuse (CSA), and childhood exposure to IPV —and subsequent intimate partner violence (IPV) in adulthood (physical, sexual or emotional). Results When potential confounders were controlled, CPA, CSA and childhood exposure to IPV were associated with IPV in adulthood for both sexes (odds ratios, 1.7, 1.8 and 2.0 for men, and 2.2, 2.0 and 2.1 for women). When severity and frequency of CM were examined, a dose-response relationship between all three types of CM and IPV in adulthood was observed among women (meaning that as the severity/frequency of CM increased, the likelihood of reporting IPV also increased); among men, a dose-response relationship was observed only for CPA. Conclusions The association between CM and IPV in adulthood is particularly concerning because experiencing multiple forms of trauma has cumulative effects. Lifespan studies have shown that individuals who experience multiple incidents of abuse exhibit the highest levels of impairment. This underscores the importance of programs to eradicate both CM and IPV. This underscores the importance of programs to eradicate both CM and IPV. Future research should focus on assessing interventions designed to promote healthy relationships and the provision of emotional support and coping mechanisms to children and families in abusive situations.