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Uncovering ‘hidden’ violence against older people

By Dr Anastasia Fadeeva, VISION Research Fellow

Violence against older people is often overlooked. As a society, we often associate violence with young people, gangs, unsafe streets, and ‘knife crime’. However, violence also takes place behind front doors, perpetuated by families and partners, and victims include older people. 

Some older people may be particularly vulnerable due to poorer physical health, disability, dependence on others, and financial challenges after retirement. Policy rarely addresses the safety of this population, with even health and social care professionals sometimes assuming that violence does not affect older people. For example, doctors may dismiss injuries or depression as inevitable problems related to old age and miss opportunities to identify victims (1). In addition, older people may be less likely to report violence and abuse because they themselves may not recognise it, do not want to accuse family members, or out of fear (2). 

Given victims of violence often remain invisible to health and social services, police, or charities, the most reliable statistics on violence often come from national surveys such as the Crime Survey for England and Wales (CSEW) conducted by the Office for National Statistics. However, for a long time the CSEW self-completion – the part of the interview with the most detail on violence and abuse – excluded those aged 60 or more, and only recently extended to include those over 74. Some national surveys specifically focus on older people, but these ask very little about violence and abuse. Additionally, despite people in care homes or other institutional settings experiencing a higher risk of violence, it can be challenging to collect information from them. Therefore, many surveys only interview people in private households, which excludes many higher-risk groups.

We need a better grasp of the extent and nature of violence and abuse in older populations. First, reliable figures can improve the allocation of resources and services targeted at the protection of older people. Second, better statistics can identify the risk factors for experiencing violence in later life and the most vulnerable groups.

In the VISION consortium, we used the Adult Psychiatric Morbidity Survey (APMS 2014) to examine violence in people aged 60 and over in England (3). While we found that older people of minoritised ethnic backgrounds are at higher risk of violence (prevalence of 6.0% versus 1.7% in white people in 12 months prior to the survey), more research needs to be done to distinguish the experiences of different ethnic groups. Our research also showed that loneliness and social isolation were strongly related to violence in later life. Older people may experience social isolation due to limiting health issues or economic situations, and perpetrators can exploit this (4). Moreover, isolation of victims is a tool commonly used by perpetrators, especially in cases of domestic abuse (5).  Knowing about these and other risk factors can help us better spot and protect potential victims.

Additionally, more needs to be learnt about the consequences of life course exposure to violence for health and well-being in later life. This is still a relatively unexplored area due to limited data and a lack of reporting from older victims and survivors. It is sometimes more difficult to establish the link between violence and health problems because the health impacts are not always immediate but can accumulate or emerge in later life (6). Also, as people develop more illnesses as they age, it is more challenging to distinguish health issues attributable to violence. Therefore we are also using the English Longitudinal Study of Ageing (ELSA) to examine temporal relationships between lifetime violence exposure and health in older age.

In an inclusive society, every member should be able to lead a life where they feel safe and respected. We are delighted that the CSEW has removed the upper age limit to data collection on domestic abuse, which is one step towards making older victims and survivors heard. Continuous work on uncovering the ‘hidden’ statistics and examining the effects of intersectional characteristics on violence is crucial in making our society more inclusive, equal, and safe for everyone. For example, one VISION study (7) has demonstrated that the risks of repeated victimisation in domestic relationships had opposite trends for men and women as they aged. We are committed to support the Hourglass Manifesto to end the abuse of older people (8), and are willing to provide decision makers with evidence to enable a safer ageing society.

Footnotes

  • 1.  SafeLives U. Safe later lives: Older people and domestic abuse, spotlights report. 2016.
  • 2.  Age UK. No Age Limit: the blind spot of older victims and survivors in the Domestic Abuse Bill. 2020.
  • 3.  Fadeeva A, Hashemi L, Cooper C, Stewart R, McManus S. Violence against older people and mental health: a probability sample survey of the general population. forthcoming.
  • 4.  Tung EL, Hawkley LC, Cagney KA, Peek ME. Social isolation, loneliness, and violence exposure in urban adults. Health Affairs. 2019;38(10):1670-8.
  • 5.  Stark E. Coercive control. Violence against women: Current theory and practice in domestic abuse, sexual violence and exploitation. 2013:17-33.
  • 6.  Knight L, Hester M. Domestic violence and mental health in older adults. International review of psychiatry. 2016;28(5):464-74.
  • 7.  Weir R. Differentiating risk: The association between relationship type and risk of repeat victimization of domestic abuse. Policing: A Journal of Policy and Practice. 2024;18:paae024.
  • 8.  Hourglass. Manifesto A Safer Ageing Society by 2050. 2024.

Contact Anastasia at anastasia.fadeeva@city.ac.uk

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Mental health in the workplace: how employers should respond to domestic violence

This event is in the past.

VISION member Sally McManus will be talking at a Westminster Insight event on Supporting Women’s Health in the Workplace on 20 March 2024.

Sally will use a life-course approach to understanding women’s mental health and wellbeing at work, including the impact of the psychosocial working environment, bullying and harassment at work, and what support and signposting employers can offer in relation to domestic violence.

For further information, please contact Sally at sally.mcmanus@city.ac.uk

Photo by Etty Fidele on Unsplash

Dr Annie Bunce receives award at Lancet Public Health Science conference

Dr Annie Bunce

Dr Annie Bunce, VISION Research Fellow, was awarded Best Oral Presentation at the Lancet Public Health Science conference in London this November. She presented on the Prevalence, nature and associations of workplace bullying and harassment with mental health conditions in England: a cross-sectional probability sample survey.

Annie’s research, conducted with VISION colleagues Ladan Hashemi, Sally McManus, and others, presents the first nationally representative findings on the prevalence of workplace bullying and harassment in England for over a decade. Annie analysed data from the 2014 Adult Psychiatric Morbidity Survey (APMS) to demonstrate: the prevalence of workplace bullying and harassment (WBH) in the working population in England; the nature of WBH experienced, who it was perpetrated by and the types of behaviour it involved; and associations between the experience of WBH and indicators of adverse mental health.

The study is unique in that the APMS makes robust assessments of mental health – operationalising diagnostic criteria – which provides an accurate assessment of clinical need. Implications for employers, policymakers, health services and researchers are outlined.

For the article, please see: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02066-4/fulltext

Please contact Annie at annie.bunce@city.ac.uk for further information.

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Intimate partner violence: Asking the right questions?

VISION Interim Director Gene Feder collaborated with Valeria Skafida from the University of Edinburgh and Christine Barter from the University of Central Lancashire to undertake a critical analysis of UK longitudinal and repeated cross-sectional population surveys which asked about experiences of intimate partner violence and abuse (IPVA).

Seven relevant UK representative population-based surveys which asked about IPVA among adults and/or young people (16–17 years old) were identified. They critically engaged with the questionnaires to analyse the strengths and limitations of existing UK data on IPVA.

Several limitations in UK surveys were identified. Many questions still showed a bias, partly historical, towards collecting more data about physical abuse. Few surveys asked about financial abuse, abuse post-separation or through child contact, or through technologies, though improvements were under way.

Surveys still sought to count incidents of abuse, instead of enquiring about the impact of abusive behaviours on victims. Ethnicity and other demographic variables were not always adequately captured (or accessible to data users), making it difficult to explore aspects of inequality. Potentially useful comparisons within the UK were difficult to undertake given the increasingly divergent questionnaires used in different UK nations.

They discussed how future iterations of existing surveys or new surveys can improve with regards to how questions about IPVA are asked. Given that surveys across geographical contexts often suffer similar weaknesses, their findings are relevant for IPVA survey methodology beyond the UK context.

For further information please see: Asking the Right Questions? A Critical Overview of Longitudinal Survey Data on Intimate Partner Violence and Abuse Among Adults and Young People in the UK | SpringerLink