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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.

Dr Sophie Carlisle, Evaluation Researcher at Health Innovation East Midlands, and former VISION researcher, also reflects on violence against older people and includes an analysis of our study’s strengths and weaknesses in her 10 December 2024 blog on the Mental Elf website, Violence against older people – linked to poor mental health #16DaysOfActivism2024. Sophie highlighted how the study reported that violence against older people is often perpetrated by an intimate partner and is strongly associated with poor mental health.

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.

For further information, please see: Violence against older people and associations with mental health: A national probability sample survey of the general population in England – ScienceDirect

Or please contact Anastasia at anastasia.fadeeva@city.ac.uk

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.

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Presentations from the 2024 VISION Annual Conference

The presentations from the 3rd VISION annual conference are now available for downloading.

The event was held at Kings College London, Strand campus, on 11 June. The theme was Violence prevention in research and policy: Bridging silos. Keynote speakers, Dr Claudia Garcia-Moreno (World Health Organisation) and Professor Katrin Hohl (City, UoL) considered the changes needed for effective violence prevention from the perspectives of health and justice. Three symposiums highlighted interdisciplinary research from the VISION consortium and partners on:

– Violence against older people: Challenges in research and policy;

– Learning across statutory review practices: Origins, ambitions and future directions; and

– Responding to experiences and expressions of interpersonal violence in the workplace

Approximately 80 academics, central and local government officials, practitioners, and voluntary and community sector organisations attended from a range of health and crime / justice disciplines.

All the slides that could be shared are available below. Please feel free to download.

Photo caption: Symposium 3, ‘Responding to experiences and expressions of interpersonal violence in the workplace’. From left to right: Chair, Dr Olumide Adisa (University of Suffolk) and Panellists Dr Vanessa Gash (City, UoL), Dr Alison Gregory (Alison Gregory Consulting), Catherine Buglass (Employers’ Initiative on Domestic Abuse) and Dr Niels Blom (City, UoL)

Professor Gene Feder, VISION Director – Welcome – 1 download

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Keynote Speaker, Dr Claudia Garcia-Moreno – Violence against women: From research to policy and action – 1 download

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Symposium 1 – Violence against older people: Challenges in research and policy – 4 downloads (Hourglass, Office for National Statistics, Public Health Wales & VISION)

Symposium-1_Older-people-and-violence_HourglassDownload
Symposium-1_Older-people-and-violence_ONSDownload
Symposium-1_Older-people-and-violence_PHWDownload
Symposium-1_Older-people-and-violence_VISIONDownload

Symposium 2 – Learning across statutory review practices: Origins, ambitions and future directions – 1 download

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Symposium 3 – Responding to experiences and expressions of interpersonal violence in the workplace – 3 downloads (Employers’ Initiative on Domestic Abuse, and 2 from VISION)

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Symposium-3_Violence-and-the-workplace_EIDADownload
Symposium-3_Violence-and-the-workplace_VISION-2Download

Trends in outcomes used to measure the effectiveness of domestic and sexual violence and abuse services: a scoping review

In the UK, domestic and sexual violence and abuse (DSVA) is prevalent, and a range of support services and interventions are available to those who have experienced or perpetrated it. Currently, there is no consensus on how the effectiveness and impact of these services should be measured, nor is it clear what outcomes and outcome measures are currently being used by service providers and researchers.

In 2022, VISION researchers, led by Dr Sophie Carlisle, co-designed and conducted a scoping review with an advisory group of representatives from six UK-based DSVA organisations, to summarise, map and identify trends in outcome measures used in evaluations and studies of DSVA services and interventions in the UK.

They searched eight databases, four grey literature databases, put out a call for evidence and searched relevant DSVA websites and identified a total of 80 studies describing 87 interventions and services that were relevant to the review.

A total of 426 outcome measures were extracted, of these there were 282 unique outcome measures. The most commonly used outcome, reported in 11 studies, was the cessation of abuse, as measured by the Severity of Abuse Grid. Over time, both the number of studies and the variety of outcome measures has increased.

This research highlights inconsistencies in measurements of effectiveness in evaluations of DSVA services and research. As this area matures, there is an increased need for a core of common, reliable metrics.

For further information please see: Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review | BMJ Open

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Unleashing social media potential to research violence against women and girls in Iran

Researching violence against women and girls (VAWG) in low- and middle-income countries (LMICs) presents unique challenges, primarily due to various contextual factors that hinder conventional survey methodologies. These challenges include limited funding, political obstacles, and safety concerns for both researchers and participants. Consequently, traditional survey approaches may prove unfeasible or inadequate in capturing the complex realities of VAWG in these settings.

VAWG is a particularly pressing issue in Iran, a Middle Eastern country marked by its patriarchal structure and systematic and pervasive gender discrimination. The patriarchal and legal structure of the country perpetuates gender inequalities and reinforces societal norms that tolerate or even condone violence against women. Yet, understanding the full scope of VAWG in Iran remains hindered by a lack of robust data.

In a recently published study, VISION researchers, Ladan Hashemi and Sally McManus, collaborated with counterparts from Bristol University (Nadia Aghtaie) and Iran (Fateme Babakhani) to explore the effectiveness of social media in recruiting victims of violence in Iran, shedding light on their experiences and the potential of social media as a research tool.

The findings revealed valuable insights into the manifestation and context of VAWG in Iran. Social media recruitment proved to be effective in reaching a diverse sample of victims and provided crucial insights into the dynamics of violence, the identities of perpetrators, and the settings where violence occurs. Victims often reported experiences from more than one type of perpetrator, spanning both public and domestic spheres. While social media recruitment offers broad reach and a safer environment for data collection, it also presents challenges such as sampling biases which affect the generalisability of findings.

For further information please see: Social Sciences | Free Full-Text | Using Social Media to Recruit Seldom-Heard Groups: Reaching Women and Girls with Experience of Violence in Iran (mdpi.com)

Or contact Ladan at ladan.hashemi@city.ac.uk  

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Referral outcomes for victim-survivors of sexual violence accessing specialist services

Sexual violence and abuse (SVA) is highly prevalent globally, has devastating and wide-ranging effects on victim-survivors, and demands the provision of accessible specialist support services.

In the UK, Rape Crisis England & Wales (RCEW), a voluntary third sector organization, is the main provider of specialist SVA services. Understanding the profile of victim-survivors who are referred to RCEW and their referral outcomes is important for the effective allocation of services.

Using administrative data collected by three Rape Crisis Centres in England between April 2016 and March 2020, VISION researchers Annie Bunce, Niels Blom and Estela Capelas Barbosa, used multinomial regression analysis to examine the determinants of victim-survivors’ referral outcomes, controlling for a wide range of potentially confounding variables.

They discovered that support needs, more so than the type of abuse experienced, predicted whether victim-survivors were engaged with services. Particularly, the presence of mental health, substance misuse and social, emotional, and behavioral needs were important for referral outcomes. The referral source also influenced referral outcomes, and there were some differences according to demo-graphic characteristics and socioeconomic factors.

This research was co-produced with stakeholders from RCEW, who informed interpretation of these findings.

For further information please see: Determinants of Referral Outcomes for Victim–Survivors Accessing Specialist Sexual Violence and Abuse Support Services (tandfonline.com)

Or contact Annie at annie.bunce@city.ac.uk  

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Bystander experiences of domestic violence and abuse during COVID

VISION researchers Alex Walker, Bryony Perry, Emma R Barton, Lara Snowdon and Mark Bellis surveyed people in Wales about their experiences of being a bystander to domestic violence and abuse (DVA) during the COVID-19 pandemic, with their colleagues at University of Exeter, Public Health Wales, and University of Durham.

This research provides a unique perspective on DVA during a global pandemic, and therefore offers important new evidence that can contribute to DVA prevention during public health emergencies. 

Globally, professionals voiced concern over the COVID-19 restrictions exacerbating conditions for DVA to occur. Yet evidence suggests this also increased opportunities for bystanders to become aware of DVA and take action against it. This mixed methods study consists of a quantitative online survey and follow-up interviews with survey respondents. Conducted in Wales, UK, during a national lockdown in 2021, this article reports on the experiences of 186 bystanders to DVA during the pandemic.

The researchers found that while public health restrictions exacerbated DVA, they also increased the opportunity for bystanders to become aware of DVA, and to take prosocial action. Results support the bystander situational model whereby respondents have to become aware of the behaviour, recognise it as a problem, feel that they possess the correct skills, and have confidence in their skills, before they will take action.

Having received bystander training was a significant predictor variable in bystanders taking action against DVA; this is an important finding that should be utilised to upskill general members of the community.

For further information please see: Bystander experiences of domestic violence and abuse during the COVID-19 pandemic in: Journal of Gender-Based Violence – Ahead of print (bristoluniversitypressdigital.com)

Or contact Lara at lara.snowdon@wales.nhs.uk  

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Differentiating risk: The association between relationship type and risk of repeat victimization of domestic abuse

Much of the literature on domestic abuse focuses on those in intimate partner relationships or ex-partners, however, in the UK the Home Office definition also includes those in familial relationships. The Domestic Abuse, Stalking, and Harassment and Honour-Based Violence Risk Assessment assumes homogeneous risk factors across all relationships.

This paper, Differentiating risk: The association between relationship type and risk of repeat victimization of domestic abuse, therefore examines the risk factors for repeat victimization of domestic abuse by relationship type between the victim and perpetrator in a UK police force.

Using police-recorded domestic abuse incident and crime data, a logistic regression model found that the most similar repeat victimization risk profiles for 14,519 victims were amongst partners and ex-partners, with both relationships demonstrating the greatest degree of gender asymmetry, compared with other familial relationships. Physical violence was the strongest predictor of repeat victimization and was a statistically significant predictor for ex-partners, partners, and all familial relationships. Coercive behaviour was also a significant predictor for all relationships apart from partners, but not at the same magnitude as physical abuse.

Recognizing the difference in risk by relationship type may assist the police in deciding the most appropriate response and interventions to reduce the risk of further harm. 

 For further information please see: https://academic.oup.com/policing/article/doi/10.1093/police/paae024/7641219?login=false

Or contact Ruth at ruth.weir@city.ac.uk  

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Prevalence of physical violence against people in insecure migration status 

VISION researchers from the Systematic Review working group (Andri Innes, Sophie Carlisle, Hannah Manzur, Elizabeth Cook, Jessica Corsi and Natalia Lewis) have published a systematic review and meta-analysis in PLOS One, estimating prevalence of physical violence against people in insecure migration status. This is the first review of its type, synthesizing global data on violence against migrants in all types of insecure status. 

The review finds that around 1 in 3 migrants in insecure status experience physical violence. Violence included physical interpersonal, community and state violence. Insecure status was conceptualised encompassing undocumented status, lapsed statuses, asylum seeking and other pending applications, and any status that embeds a form of insecurity by tying status to a particular relationship (such as spousal or employer-employee). Studies were only included in the review if the violence happened while the victim was in insecure status. 

The VISION team reviewed academic literature published between January 2000 and May 2023, across social and health sciences. The study was global in scope, although data was limited by the English language search.  

Key Findings 

More than one in four migrants in insecure status disclosed intimate partner violence specifically. Spousal visas embed a particular risk of violence because the visa status is connected to an intimate partner relationship, creating an important power disparity. Nevertheless, there was no significant difference in prevalence of violence by gender across the dataset. Prevalence also did not differ meaningfully across geographic region, perpetrator, status type or time frame.  

The most significant findings included that violence exposure is not meaningfully different for people in undocumented status than in other types of insecure status. Physical violence is a concern across all types of insecure migration status types. 

The findings were limited because of high levels of heterogeneity in the data. It was also difficult to consider intersectional identity characteristics such as age, race or ethnicity, nationality, religion, marital status, socio-economic status, education level or motivation for migration because these were not standardised across included studies. This suggests that further and specified research is needed in this area. 

The review is open access and is available to read in full here. 

If you have any comments or feedback for the authors, please contact Andri at alexandria.innes@city.ac.uk  

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Consultation: Is there a need for a VAWG data dashboard?

This consultation has closed.

In 2022, the UK Office for National Statistics (ONS) developed a prototype violence against women and girls (VAWG) dashboard. The tool presents statistics and charts on violence against women and girls in England and Wales, drawing on multiple sources. However, due to re-prioritisation at ONS, maintenance of the dashboard was halted and from 1st April 2024 it will no longer be accessible.

The VISION consortium is consulting on whether there is need for a VAWG data dashboard. This consultation is seeking views on:

  •  Whether the dashboard was useful
  •  Who used it and why
  •  If the dashboard was to continue, what aspects should be kept, dropped or added.

The Qualtrics consultation link is now closed because the consultation is over.

Anyone interested in the idea of a VAWG data dashboard is welcome to respond to the survey, particularly if interested in using one in the future.

Answer as many questions as you like. You can provide contact details or complete this anonymously. The findings will be used to draft a report and provide recommendations on whether the dashboard should continue. The report will include a list of the groups and organisations that participated (where details are provided). Individuals will not be named, although quotes may be taken from the text provided. The report may be published, for example on the VISION website.

The ONS VAWG dashboard was available online until 31 March 2024. Therefore, if you would like to participate in this consultation, please view the sample screenshots of the tool below.

This consultation closed Monday 22 April.

For further information, please contact us at VISION_Management_Team@city.ac.uk

Sample-screenshots-of-ONS-VAWG-dashboardDownload