In 2018, the proportion of female decedents between the ages of 0-18 with and without Society involvement was 43% (n=196) which a binomial test indicated was lower than the expected 50%, p is less than 0.001.  This is consistent with what has been observed in previous years. 

Charts 13 demonstrates the proportion of coroner investigations with and without Society involvement within the percentage of all paediatric deaths between the ages of 0-18 that occurred across five age groups in Ontario. 

The number of deaths with Society involvement was compared to the number of coroner investigations without such, across age groups to evaluate if the Society involved population was the comparable to the population of paediatric deaths that are the subject of a coroner’s investigation without Society involvement.

The 2018 data, within the context of limitations noted earlier, demonstrated a significant association between individuals under the age of one who had Society involvement within a year of their death, which is similar to previous years (Chi-square test was performed 2 (4, n=433) = 14.861, p = 0.005.  Relationship between the age group of less than 1 year with Society involvement was significant, where residual for this age group was greater than 2, (2.24)). 

The proportion of deaths across age groups was similar from each year, from 2013-2017.

Chart 13 compares the proportion of coroner investigations with and without Society involvement within the percentage of all paediatric deaths of children and youth between the ages of 0-18 in Ontario across five age groups in 2018. The data demonstrates that of the coroners’ investigations, there was a significant difference from the expected number of deaths for those under the age of one who had involvement with a Society within a year of their death compared to those with no Society involvement.  There was no significant difference in other age groups.

Chart 13: Proportion of deaths across age groups in 2018

 

Chart 13: there was a significant difference from the expected number of deaths for those under the age of one with a Society compared to those with no Society involvement.  No significant difference in other age groups.

 

The regional distribution of Ontario’s paediatric population and paediatric deaths correlate (see Chart 14); however, analysis of the available data shows that there is a significant difference across the four regions of Ontario, between the proportion of paediatric deaths in Ontario and the proportion of Coroner's investigations in Ontario with Society Involvement. Specifically, there was a negative association between Society involvement and those who died in Central Region (Chi-square test was performed.  Relation between the variables was significant, 2 (3, n=433 in 2018) = 13.589, p is less than 0.0035. Negative relationship between the Central Region and Society involvement was significant, where absolute residual was greater than 2, (-2.34)).

As in previous years, fewer deaths with Society involvement appear to occur in the Central region when compared to the overall number of child deaths in Ontario and the data continue to suggest that more deaths with Society involvement occur in the North when compared to the overall number of child deaths in Ontario. While it is still elevated, there was a slight decrease in 2018 compared with previous years and there has been an increase in the proportion of deaths with Society involvement in the East and West Regions.  In 2018, five percent of paediatric deaths in Ontario occurred in the North overall, with 15% of all Ontario paediatric deaths with Society involvement occurring in that region.  Similarly, in the West Region, while 27% of paediatric deaths in Ontario occurred in the West Region, 39% of all Ontario paediatric deaths with Society involvement occurred in that region.

As noted in previous annual reports, there are a number of potential reasons that may be associated with the apparent overrepresentation of child and youth deaths with Society involvement in the North, including but not limited to: lower health status, challenges to accessing healthcare services and higher mortality rates that increase with remote place of residence (The Northern and Rural Healthcare Panel (2011, March 30). Rural and Northern Healthcare Report Executive Summary).

In 2018, available data indicated that 61% of the deaths with Society involvement that occurred in the North region were Indigenous children and youth. This is lower than what was observed in the previous two years and closer to what was observed in 2014 and 2015.

Chart 14 illustrates that the percentage of paediatric deaths occurring in each region of the province is generally the same as the percentage of children and youth across Ontario, by region. More deaths with Society involvement occurred in the North (16%) and the West (41%), when compared to the number of paediatric deaths that occurred in that region as a proportion of total paediatric deaths in Ontario (5% and 27%, respectively). Note: The Office of the Chief Coroner Central Region boundaries include Toronto.

Chart 14: Proportions of paediatric population in Ontario, paediatric deaths in Ontario, and coroner’s investigations in Ontario with Society involvement, 2018, by region

 

Chart 14: More deaths with Society involvement occurred in the North (16%) and the West (41%)