Living a lifetime of consequences: Maltreatment can hurt a child's future

Photo Credit: Tarek Afifi

CIHR Foundation Grant Recipient

Dr. Tracie O. Afifi
Associate Professor
Faculty of Health Sciences, University of Manitoba

Dr. Afifi's Research

Dr. Tracie Afifi, an epidemiologist at the University of Manitoba, studies the relationships between child maltreatment and mental and physical health problems in childhood, adolescence, and later in adulthood. Through her work, this CIHR-funded researcher has earned wide recognition as a staunch defender of children, especially when it comes to their right to live free from the fear of physical and emotional harm.

She has spent the past several years exploring novel epidemiological research avenues in order to inform public policy and improve child maltreatment prevention and intervention strategies and services in Canada.

Epidemiology: the branch of medicine that deals with the incidence, distribution and possible control of disease and other factors related to health (Oxford Dictionary)

Leading a tenacious team of researchers, Dr. Afifi has been teasing out valuable information from population-based datasets in order to demonstrate that violence during childhood is linked with detrimental mental and physical health outcomes. The consequences of child maltreatment are profound and can have a negative impact on health across the lifespan.

Dr. Afifi believes that a serious gap remains between understanding the harms related to child maltreatment and effective prevention strategies. Her research goals focus on developing strategies to prevent child maltreatment and thereby change a child's trajectory, improve health, and strengthen families.

Importantly, the imprint of negative experiences as a child resulting from exposure to physical discipline, physical or sexual abuse, emotional maltreatment, neglect, or exposure to intimate partner violence, can linger well into adulthood.

Dr. Afifi's work has established the impact that child maltreatment can have in later life, triggering mental health challenges including depression, anxiety, problems with alcohol and drugs, gambling problems, and suicidal thoughts and attempts. Her work has also linked child maltreatment to poor adult physical health conditions such as arthritis, back problems, migraine headaches, and obesity.

Her research also shows that people who are mistreated as children experience an increased likelihood of homelessness, poor health-related quality of life, and violence in adult relationships. This makes life even more challenging for individuals who have developed health and social challenges as a result of being mistreated.

In 2012, when Dr. Afifi and her colleagues published their CIHR-funded study with the recommendation that "physical punishment should not be used on children of any age," they sparked an international discussion on the negative mental health effects of physical punishment as a means of disciplining children. The reaction was fast and furious on both sides of the debate. Many applauded her work, hailing it as being pivotal, while spanking proponents criticized her study and defended this method of child discipline.

Resolute in her determination to continue to conduct high-quality and innovative studies that contribute to the scientific literature on physical punishment and child maltreatment, Dr. Afifi remains an advocate for children.

"Warmer and closer relationships with our kids are created with non-physical and positive parenting approaches that guide our children. Simply stated, there is no reason to ever spank a child," said Dr. Afifi.

Supporting advances in strengthening families and improving childrens' long-term mental health outcomes

With her latest project, "Preventing child maltreatment: Changing a child's trajectory, improving health, and strengthening families," Dr. Afifi continues to build on her earlier work. Recognizing the dearth of Canadian data, she will lead a primary data collection, secondary data analyses, and linkages to administrative health data to advance knowledge in Manitoba and Canada.

The objectives are to understand the size and scope of child maltreatment within a Canadian context; to identify protective factors at the various levels (individual, family and community) associated with a decreased likelihood of child maltreatment, the increased likelihood of improved health outcomes following child maltreatment; and, to apply this knowledge to develop new evidence-based intervention strategies or to modify existing programs.

A clearer understanding of the different types of abuse experienced among children and youth will inform effective interventions, help tailor programs, and allow for the accurate assessment of any changes to services offered to individuals grappling with mental health issues as a result of child maltreatment.

This research will go a long way to enhancing our understanding of the extent of the problem and will help to develop evidence-based prevention and intervention strategies intended to prevent maltreatment before it occurs, eliminate or minimize any recurrences, and help those who have been maltreated in childhood.

"Preventing child maltreatment from occurring will improve all aspects of one’s life and lead to healthier children, families, and communities."

Dr. Tracie Afifi

About Dr. Afifi

An internationally recognized child maltreatment researcher and child welfare advocate, Dr. Afifi was the principal investigator in Canada's first nationally representative epidemiological study examining the impact of child abuse on mental health in adulthood. After earning her Master of Science degree at the University of Manitoba, she received her Doctor of Philosophy from the same institution in 2009.

Cross-appointed as an Associate Professor of both Community Health Sciences and of Psychiatry at the University of Manitoba's Faculty of Health Sciences College of Medicine, she received a New Investigator Award from CIHR in 2013, the same year that she was recognized  by the Canadian Coalition for the Rights of Children with a Children's Rights Supporter Award.

Section 43, Protection of Persons in Authority, of the Criminal Code of Canada reads as follows:

Every schoolteacher, parent or person standing in the place of a parent is justified in using force by way of correction toward a pupil or child, as the case may be, who is under his care, if the force does not exceed what is reasonable under the circumstances.

The defence of reasonable correction appeared in Canada's first Criminal Code in 1892. The content has remained virtually unchanged since that time, with the exception of the removal of masters and apprentices from among the relationships covered by the defence. 

In December 2015, Peru became the 48th country worldwide to prohibit corporal punishment of children in all circumstances, including in the family home.

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