Inequities in child protective services contact among First Nations and non-First Nations parents in one Canadian province: a retrospective population-based study.

Background: Parental contact with child protective services (CPS) has been linked to deteriorating health among parents. Capturing rates of CPS contact among parents is therefore important for understanding inequities in exposure and their potential role in amplifying racial inequities in health and wellbeing. Though an extensive body of research in North America has provided population-level analyses of CPS contact among children, a disproportionate percentage of whom are Indigenous, no studies to date have extrapolated estimates to account for contact in parent populations, leading to a fragmented view of the system's reach and impact beyond the child-level. In order to advance health equity-oriented research in this domain, our study calculated previously unexplored population-level estimates of CPS contact among First Nations and non-First Nations parents.

Methods: We used whole-population linked data from Manitoba (Canada) to identify 119,883 birthing parents (13,171 First Nations; 106,712 non-First Nations) who had their first child between 1998 and 2019. We calculated prevalence rates, rate differences, and rate ratios of parental contact with different levels of CPS by First Nations status (categorization used in Canada for Indigenous peoples who are members of a First Nation), including ever had an open CPS file for child(ren), ever had out-of-home placement of child(ren), and ever had termination of parental rights (TPR).

Results: Overall, 49.6% of First Nations parents had a CPS file open for their child(ren) (vs. 13.1% among non-First Nations parents), 27.4% had out-of-home placement of their child(ren) (vs. 4.7% among non-First Nations parents), and 9.6% experienced TPR (vs. 1.8% among non-First Nations parents).

Conclusions: CPS contact was high among parents and prevalence was almost 4 times higher among First Nations parents, where 1 out of 2 were intervened upon by CPS. Findings reinforce significant concerns about the system's scope and the crucial importance of considering its role in compounding health inequities and sustaining colonialism in Canada. First Nations-led interventions are needed to reduce CPS disruption to the lives of First Nations peoples.