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Maternal and Child Health Journal

Published in:

01-09-2019

Family Separation and Maternal Self-rated Health: Evidence from a Prospective Cohort of Marginalized Mothers in a Canadian Setting

Authors: Kathleen S. Kenny, Flo Ranville, Sherri L. Green, Putu Duff, Melissa Braschel, Ronald Abrahams, Kate Shannon

Published in: Maternal and Child Health Journal | Issue 9/2019

Abstract

Objectives

Involuntary child removal via the child protection system disproportionately affects marginalized women, yet the impacts on maternal health are under-investigated. This study prospectively examined the association of child removal with self-rated health of mothers who are sex workers. Given high levels of intergenerational family separation in this population, particularly among Indigenous sex workers, we also estimated joint effects of child removal spanning two generations.

Methods

Analyses drew on 2010–2015 data from AESHA (An Evaluation of Sex Workers’ Health Access), a prospective cohort of sex workers (n = 950) in Vancouver, Canada. Using logistic regression with generalized estimating equations, we modeled the association of past child removal and current self-rated health in a sample of 466 sex workers who ever had a live birth. Joint effects of child removal and history of removal from own parents were also investigated.

Results

Of 466 sex workers, 180 (38.6%) reported child removal at baseline and 147 (31.6%) had a history of removal from own parents. In main effects model, child removal was associated with increased odds of poorer self-rated health [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.04, 2.16]. Joint effects model showed higher odds of poorer self-rated health (OR 2.04, 95% CI 1.27, 3.27) among women with intergenerational family separation.

Conclusion for Practice

Child removal was negatively associated with sex workers’ health that was worsened when family separation spanned two generations. Findings underscore need to develop sex worker and Indigenous-led family support services, along with tailored interventions to address health needs of those separated from their children.

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Title: Family Separation and Maternal Self-rated Health: Evidence from a Prospective Cohort of Marginalized Mothers in a Canadian Setting
Authors: Kathleen S. Kenny
Flo Ranville
Sherri L. Green
Putu Duff
Melissa Braschel
Ronald Abrahams
Kate Shannon
Publication date: 01-09-2019
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 9/2019
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-019-02762-z

At a glance: The STEP trials

Springer Medicine

Family Separation and Maternal Self-rated Health: Evidence from a Prospective Cohort of Marginalized Mothers in a Canadian Setting

Abstract

Objectives

Methods

Results

Conclusion for Practice

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion for Practice

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