Written evidence submitted by The Violence, Health, and Society (VISION) consortium [ROP0025]

 

The Violence, Health, and Society (VISION) consortium is funded by the UK Prevention Research Partnership. We are a collaboration of epidemiologists, economists, data scientists, criminologists, evaluation experts, psychiatrists and more from multiple universities. Our research brings data together from health and crime surveys, health services, police, solicitors, and third sector domestic and sexual violence specialist services.  Over the course of our five-year project, we aim to improve the measurement of data on violence to influence policy and practice and reduce violence and the health inequalities that result. One of our research focuses is violence across the lifespan, which includes violence against older people.

Stereotyping and discrimination

How prevalent is ageist stereotyping and discrimination; what forms does it take; in what areas is it most common; what its impact is on older people; and how can it best be challenged?

The lack of recognition that violence affects older people is one of the forms of discrimination against them. Older people experience violence, most frequently from their intimate partners and other family members (Fadeeva, Hashemi, Cooper, Stewart, & McManus, forthcoming). This violence, however, is more likely to go unnoticed, in part due to ageist stereotypes. Many people including those involved in strategic and policy responses to violence reduction and health and social care professionals hold false beliefs that violence is not commonly experienced in older age, practitioners therefore may be unlikely to detect and report violence in older individuals. Neglect and maltreatment of older people can also be often seen as part of normal care practices or lack of resources and therefore are tolerated (Myhre, Saga, Malmedal, Ostaszkiewicz, & Nakrem, 2020). Older people are sometimes perceived as “unimportant, disposable, and burden to the society, which can drive violence (Mahler, 2021). Additionally, because of the social exclusion of older people from many domains of the society (e.g., labour, cultural activities) (Walsh, Scharf, & Keating, 2017), violence and abuse experienced by older individuals is more likely to remain unnoticed by others.

Given an ageing society, the reduction in resources provided to support older people can also be seen as a form of discrimination. Our previous work on the English system of adult social care, showed that the real-term increase in spending on adult social care by councils since 2015 was offset by the reductions in services provided to people aged 65 or over, so unmet need for social care support among older adults remained broadly unchanged, putting them at increased risk of neglect (Burchardt, Jones, & Obolenskaya, 2018; Burchardt, Obolenskaya, & Hughes, 2020).  Older people may also be overlooked as a result of commissioning decisions that are based on datasets in which their experiences are less likely to be captured.  For example, older people are less likely to report domestic abuse to the police and therefore commissioning decisions based on police data are likely to be under resources areas in where there are higher proportions of older people (Weir, 2020).

Another form of discrimination can be the lack of tailored support to older victims of violence. For example, services do not account for health issues and/or specific needs of older victims of domestic abuse, when referring to a shelter. Sometimes older people might not be aware that services are available to them and that is because services do not effectively target older people in their messaging and campaigns (SafeLives, 2016).

There is also discrimination in terms of the amount of data that is collected on violence and abuse in later life. For example, until 2021 data collection , the Crime Survey for England and Wales (CSEW) module on domestic violence and abuse as well as sexual victimisation within the self-completion part of the survey, did not extend to those who were older than 74 years old (and until 2017, it only was administered to participants under the age of 60). The existing cohort studies on ageing in the UK (the 1970 British Cohort Study and the 1958 National Child Development Study) also have very limited or no information on violence. Additionally, surveys often collect data from people living in households only, and there is an insufficient evidence on violence on older people in institutional settings including care homes and prisons. This constitutes a serious data gap and limits our knowledge of the risks of violence and abuse experienced by older adults. More needs to be done to ensure collection of such data from all age groups, including the oldest old, to inform policy and practice. 

Intersectionality

How does “intersectionality”, for example, sex, sexual orientation, ethnicity and disability status alongside age, impact older people and require distinct policy responses?

The effects of intersectionality between older age and other characteristics are prominent in terms of both the prevalence of violence and the effects of violence and abuse on health.

For example, our research suggests that experiences of violence have a greater impact on physical and mental health of older women than older men (Fadeeva & Obolenskaya, forthcoming).

Having multiple impairments/types of disability (more likely among older people) increased the risk of experiencing intimate partner violence (IPV) for women (although this was not evident in men) (Hashemi, Manzur, Bunce, & McManus, forthcoming). Our findings also suggest that older people of non-white ethnicity experience increased rates of violence (Fadeeva et al., forthcoming). Little attention has been paid to elder abuse in black and minoritised ethnic communities, and there is a lack of evidence on how ethnicity can increase risks of violence in older age. Analyses of the CSEW found higher rates of cybercrime victimisation in older people from black and minoritised ethnic groups than among older white people (Havers, Tripathi, Burton, McManus, & Cooper, preprint). More evidence is needed on older people from black and minoritised ethnic groups, including on the effects of intersections between age and ethnicity, and how best to protect older members from black and minoritised ethnic communities from abuse and neglect.

Additionally, our findings showed that among older people exposed to violence in the past 12 months, 26.4% had a common mental disorder (CMD), compared with 10.2% in those not exposed to violence, after adjustment for demographic and socioeconomic factors (Fadeeva et al., forthcoming). This relationship between health and violence can be bi-directional, that is, those exposed to violence may be more likely to develop CMD, but also those with CMD may be at increased risk of experiencing violence.

 

References

Fadeeva, A., Hashemi, L., Cooper, C., Stewart, R., & McManus, S. (forthcoming). Violence against older people and mental health: a probability sample survey of the general population.

Fadeeva, A., & Obolenskaya, P. (forthcoming). The associations between violence and health in older age: a 13-year population-based cohort study.

Hashemi, L., Manzur, H., Bunce, A., & McManus, S. (forthcoming). Disability and Intimate Partner Violence (IPV ) in England: Gender Stratified Analyses of a Probability Sample Survey.

Havers, B., Tripathi, K., Burton, A., McManus, S., & Cooper, C. (preprint). Cybercrime victimisation among older adults: a probability sample survey in England and Wales. CrimRxiv.

Mahler, C. (2021). Report of the Independent Expert on the enjoyment of all human rights by older persons, Claudia Mahler,‘Ageism and age discrimination’ Human Rights Council Forty-eighth session (Vol. 13).

Myhre, J., Saga, S., Malmedal, W., Ostaszkiewicz, J., & Nakrem, S. (2020). Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect. BMC health services research, 20(1), 1-14.

SafeLives, U. (2016). Safe later lives: Older people and domestic abuse, spotlights report.

Walsh, K., Scharf, T., & Keating, N. (2017). Social exclusion of older persons: A scoping review and conceptual framework. European Journal of ageing, 14, 81-98.

Weir, R. (2020). Individuals, Families and Neighbourhoods: Predictors of Domestic Abuse in Essex.  

November 2023