1
|
Kenny KS, Krüsi A, Barrington C, Ranville F, Green SL, Bingham B, Abrahams R, Shannon K. Health consequences of child removal among Indigenous and non-Indigenous sex workers: Examining trajectories, mechanisms and resiliencies. Sociol Health Illn 2021; 43:1903-1920. [PMID: 34468044 PMCID: PMC8765365 DOI: 10.1111/1467-9566.13364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
The child protection system can be a highly consequential institution for mothers who are sex workers, yet scant attention has been paid to the health consequences of its policies on this population. Drawing on 31 in-depth, semi-structured interviews with 19 Indigenous and 12 non-Indigenous sex workers in Vancouver, Canada, and using the stress process model and the concept of slow violence, this study proposes a typology of four trajectories through which child removal by this system shaped sex workers' health. Results suggest that child removal has health consequences beyond the conventionally thought of mechanism of mental distress and related health sequelae, to additionally alter women's social conditions, which also carried risks for health. Notably, while trajectories of Indigenous and non-Indigenous sex workers were similar, Indigenous participants, whose families are disproportionately impacted by long-standing colonial policies of child removal, were more severely jeopardized. Findings highlight how child removal can enact violence in the form of reverberating harms to sex workers' health, further reinforcing their marginalized statuses. This study calls for greater attention to how the child protection system (CPS) may influence the health of marginalized mothers, including how health inequities may be both causes and consequences of interventions by this system.
Collapse
Affiliation(s)
- Kathleen S. Kenny
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Andrea Krüsi
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Flo Ranville
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
| | - Sherri L. Green
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brittany Bingham
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Ronald Abrahams
- Fir Square Combined Care Unit, BC Women’s Hospital, Vancouver, BC, Canada
| | - Kate Shannon
- Centre for Gender & Sexual Health Equity, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
2
|
Harp KLH, Oser CB. A longitudinal analysis of the impact of child custody loss on drug use and crime among a sample of African American mothers. Child Abuse Negl 2018; 77:1-12. [PMID: 29287167 PMCID: PMC5857224 DOI: 10.1016/j.chiabu.2017.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 12/06/2017] [Accepted: 12/18/2017] [Indexed: 05/22/2023]
Abstract
UNLABELLED This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother's care by authorities). METHODS Using data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime. RESULTS indicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate that child custody loss has negative health implications for African American mothers, potentially reducing their likelihood of regaining or retaining custody of their children. CONCLUSIONS This study highlights the need to integrate drug treatment and other types of assistance into family case plans to improve reunification rates and outcomes among mothers, children, and families. Additionally, the finding that informal loss predicts increased drug use suggests that community-based efforts within the mother's social network could be implemented to intervene before child welfare system involvement becomes necessary.
Collapse
Affiliation(s)
- Kathi L H Harp
- University of Kentucky College of Public Health, Department of Health Management and Policy, 111 Washington Avenue, College of Public Health Building, Lexington, KY 40536, United States.
| | - Carrie B Oser
- University of Kentucky, Department of Sociology, Center on Drug and Alcohol Research, Patterson Office Tower, Lexington, KY 40506, United States.
| |
Collapse
|
3
|
Kenny KS, Barrington C, Green SL. "I felt for a long time like everything beautiful in me had been taken out": Women's suffering, remembering, and survival following the loss of child custody. Int J Drug Policy 2015; 26:1158-66. [PMID: 26194783 DOI: 10.1016/j.drugpo.2015.05.024] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 05/13/2015] [Accepted: 05/28/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Child Protective Services' (CPS) placements of children in out-of-home care disproportionately impact families marginalized by poverty, racism and criminalization. CPS' mandate to protect children from neglect and abuse is frequently criticized as failing to address the multiple social and structural domains shaping parents' lives, especially mothers. METHODS We conducted a thematic narrative analysis of in-depth interviews to explore the impact of child custody loss on 19 women who use drugs residing in Toronto, Canada. We also assessed the potential roles of intersectional forms of violence and inequities in power that can both give rise to child custody loss and mediate its consequences. RESULTS Trauma was identified as a key impact of separation, further exacerbated by women's cumulative trauma histories and ongoing mother-child apartness. Women described this trauma as unbearable and reported persistent symptoms of post-traumatic stress disorder and other mental health conditions. Practices of dissociation through increased use of drugs and alcohol were central in tending to the pain of separation, and were often synergistically reinforced by heightened structural vulnerability observed in increased exposure to housing instability, intimate partner violence, and initiation of injection drug use and sex work. Women's survival hinged largely on hopefulness of reuniting with children, a goal pivotal to their sense of future and day-to-day intentions toward ameliorated life circumstances. CONCLUSION Findings highlight needs for strategies addressing women's health and structural vulnerability following custody loss and also direct attention to altering institutional processes to support community-based alternatives to parent-child separation.
Collapse
Affiliation(s)
- Kathleen S Kenny
- Department of Maternal and Child Health, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 401 Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, USA.
| | - Clare Barrington
- Department of Health Behavior, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC 27599-7400, USA
| | - Sherri L Green
- Department of Maternal and Child Health, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 401 Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, USA
| |
Collapse
|