{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:41:20Z","timestamp":1780324880531,"version":"3.54.1"},"reference-count":36,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Marcelo L. Urquia","award":["CIHR Canadian Research Chair in Applied Population"],"award-info":[{"award-number":["CIHR Canadian Research Chair in Applied Population"]}]},{"name":"Kathleen S. Kenny","award":["CIHR FDN-154280 of Marcelo L. Urquia"],"award-info":[{"award-number":["CIHR FDN-154280 of Marcelo L. Urquia"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>While literature has documented strong gradients in child maltreatment (CM) by socioeconomic status and family composition in the general population, how these patterns extend to immigrants remain inconclusive. Using population-based administrative data, we examined, for the first time, whether gradients in CM by neighbourhood income and childbirth order vary by immigrant status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used linked hospitalisation, emergency department visits, small-area income, birth and death records with an official Canadian immigration database to create a retrospective cohort of all 1\u00a0240\u00a0874 children born from 2002 to 2012 in Ontario, Canada, followed from 0 to 5\u00a0years. We estimated rate ratios of CM among immigrants and non-immigrants using modified Poisson regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>CM rates were 1.6 per 100 children among non-immigrants and 1.0 among immigrants. CM was positively associated with neighbourhood deprivation. The adjusted rate ratio (ARR) of CM in the lowest neighbourhood income quintile versus the highest quintile was 1.57 (95% CI 1.49 to 1.66) for non-immigrants and 1.33 (95% CI 1.15 to 1.54) for immigrants. The socioeconomic gradient disappeared when restricted to children of immigrant mothers arrived at 25+ years and in analyses excluding emergency department visits. Compared to a first child, the ARR of CM for a fourth or higher-order child was 1.75 (95% CI 1.63 to 1.89) among non-immigrants and 0.57 (95% CI 0.44 to 0.74) among immigrants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Immigrants exhibited lower CM rates than non-immigrants across neighbourhood income quintiles and differences were greatest in more deprived neighbourhoods. The contrasting birth order gradients between immigrants and non-immigrants require further investigation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2019-212759","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T17:22:08Z","timestamp":1600276928000},"page":"22-28","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Do socioeconomic and birth order gradients in child maltreatment differ by immigrant status?"],"prefix":"10.1136","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9531-5213","authenticated-orcid":false,"given":"Kathleen S","family":"Kenny","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Max Rady College of Medicinea, University of Manitoba, Winnipeg, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Pulver","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"O\u2019Campo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada"},{"name":"Li Ka Shing Knowledge Institute, St.Michael\u2019s Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Guttmann","sequence":"additional","affiliation":[{"name":"Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Canada"},{"name":"Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo L","family":"Urquia","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Max Rady College of Medicinea, University of Manitoba, Winnipeg, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,16]]},"reference":[{"key":"2025100301120166000_75.1.22.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61087-8"},{"key":"2025100301120166000_75.1.22.2","doi-asserted-by":"crossref","unstructured":"Berger LM , Waldfogel J . 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