Aboriginal babies made up 71 per cent of infant deaths reviewed by B.C. children's advocate

British Columbia's Representative for Children and Youth has just issued an "aggregated, in-depth" report into the recent deaths of 21 infants in that province.

The total number of deaths in B.C. within the time period examined was actually 69. Moreover, that figure refers to 69 cases "reported to the Representative," suggesting more, unreported, infant deaths may have in fact occurred in B.C. over that time. Under the methodology employed by the Representative, the report screened out 48 cases

The 21 cases of infant death that remained were chosen as a subset for study because they each fulfilled at least one of the following three scenarios: a) the infant (or his/her family)"received a reviewable service" a year prior to death, and it's thought "the policies or practices of a public body or director may have contributed," and the death involved "an example of a recurring circumstance observed in other deaths"; b) "the death occurred in unusual or suspicious circumstances"; c) "the death was or may have been due to child maltreatment.

Fifteen of these fatalities [examined by the Representative] were Aboriginal -- that's 71 per cent of those deaths, in a province where Aboriginal infants (0-4 years) make up just 8 per cent of the overall infant population.

It's worth noting that the report does mention that "2006 data from the Ministry of Health [reveals] there is an average of 27 Status Indian infant deaths each year in British Columbia" (though no indication is given as to the time period used or the operational definition of infant, i.e., whether it's 0-1 or 0-4 years of age). That, of course, does not include deaths of Métis, Inuit or non-Status Indian infants, so the actual figure is likely higher for the Aboriginal infant population as a whole

Entitled Fragile Lives, Fragmented Systems: Strengthening Supports for Vulnerable Infants, the investigation looked into the circumstances surrounding deaths over the 23-month period of June 1, 2007 to May 1, 2009.

In all cases, the report indicated that "the infants' families were involved with the [B.C.] Ministry of Children and Family Development," and "all of these infants lived in serious poverty."

Beyond identifying these correlations, the report offered seven main recommendations:

1. That B.C. develop a non-partisan child poverty plan, with leadership from the Premier's Office... [including] a progress report by June 1, 2011. The plan should involve Aboriginal leaders and the federal government as partners.

2. That [B.C.'s Ministry of Children and Family Development, aka MCFD] develop a clear policy and evidence-based strategies to support all vulnerable families in which the mother is pregnant... [including] appropriate service strategies with Aboriginal communities.

3. That MCFD develop clear standards of practice for situations in which children and infants are placed in respite care... [with] province-wide application, including delegated Aboriginal Agencies.

4. That the Ministry of Health Services lead the development of a clear practice protocol to support effective and responsive public health nursing practice when nurses are working with high-risk infants in vulnerable families.

5. That the Ministry of Health Services lead an initiative with MCFD and other partners to develop and implement a creative social marketing campaign on safe sleeping.

6. That MCFD take immediate action to implement improvements to the case review function to enable management and staff in the ministry and other agencies serve vulnerable children to learn from the results of the reviews.

7. That MCFD implement previous recommendations made by the Representative with respect to re-establishing the role of Provincial Director [by no later than April 1, 2011] in order to support an effective process for case reviews, to avoid conflicts of interest and accountability and to drive more effective organizational learning.

Most of the above recommendations come with a timetable: a "progress report should be provided to the Representative by June 30, 2011," and standards "fully implemented by January 31, 2012."

Here's hoping the province and Canadian Prime Minister Stephen Harper -- who apologized for the damage done to thousands of Aboriginal children forced into residential schools and has been a recent crusader on behalf of improving maternal and infant health in other parts of the world -- take the report to heart.

[Editor's note: After publishing the above story on Media Indigena, writer Rick Harp added the following coda:]

The more I look into how data is collected for Aboriginal health, the more of a mess (and minefield) it becomes. And rather than endlessly insert "updates" into the original piece, I thought I'd add info via comments. 

To wit, I have now tracked down exact data for overall infant mortality in BC as listed in the "Selected Vital Statistics and Health Status Indicators" for 2009, figures published annually by the British Columbia Vital Statistics Agency (see pp. 22-23). 

There, we see that the total number of infant mortality deaths were 172 (in 2007), 165 (in 2008) and 151 (in 2009). Taken together, that 2007-2009 period (roughly the period examined by The Representative)yields a yearly average of 162 total infant deaths: which means the aforementioned average number of 27 Status Indian infant deaths would equal just under 17 per cent of all such deaths in the province (or almost double their percentage of B.C.'s infant population).

But here too these numbers could be skewed: for one, I don't know what the operational definition of infant is for that 27 Status Indian infant deaths figure. Is it 0-1 years of age, or 0-4? It becomes challenging to make meaningful comparisons. And then, check out this statement from Vancouver Coastal Health's "Aboriginal Health Status Profile" from August 2009:

"Current provincial and national systems collect health information for Aboriginal peoples identified by a legal definition of Status Indian only. Thus, BC health statistics do not include individuals who are Métis, Inuit, and non-status First Nations, or about one third of BC's Aboriginal people (emphasis mine). The data collected for Status Indians is used as a proxy for all Aboriginals."

Moreover: 

"Data sharing between jurisdictions and varying levels of government is complex, and, for historical reasons, difficult to change. Poor data sharing and multiple administrative agencies result in a patchwork of information and prohibitive reporting requirements for Aboriginal communities. This is further reinforced by inadequate infrastructure and human and fiscal resources to support Aboriginal data collection efforts. Data is frequently out-dated because of lags resulting from the multiple legal and logistical issues that arise, such as the need to match varying data sets."

"The complexity of data sharing has resulted in systematic errors in the collection and interpretation of data. For example, there was a systematic error in how infant mortality data was collected by B.C. Vital Statistics from 1998-recent, where paternal Indian Status was not captured on birth records. This resulted in a vastly underestimated infant mortality rate" (emphasis mine).

Rick Harp is the founder and president of Media Indigena, which first printed a version of this story. He has been a host/producer with the Aboriginal Peoples Television Network for many years, and also served as artistic director for the Winnipeg Aboriginal Film Festival. He is a member of the Peter Ballantyne Cree Nation in northern Saskatchewan.

 

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