The project entitled "Socio-economic and health determinants of elder abuse" had the general purpose of evaluating the social, economic and health determinants of abuse of the elderly in a context of the crisis in Portugal, experienced between 2008 and 2011, at European and, in particular, Portuguese level. The research carried out sought to highlight the effects of the socio-economic crisis on the older population (60 and over) and its relationship with the abuse of the elderly. The design of the investigation was based on a mixed methodological approach, leading to the realization, at first, of a quantitative study, and later, of a qualitative study. The empirical support of the research was based on a population cohort of Oporto city - EPIPorto, created and coordinated by ISPUP, which has followed 2485 residents, aged 18 or over, since 1999. Our research focused on elderly participants in the referred cohort (N = 1222). This sample supported the quantitative analysis, with the use of a questionnaire survey to a final sample of 678 individuals aged 60 and over, in order to support, at a later stage, the achievement of the qualitative study, using 45 semi-structured interviews, to deepen some of the analytical dimensions related with elder abuse.
The social relevance of the project resides in the contribution it can have to fill the scarcity of studies and empirical research that is observed in Portuguese society, regarding this relationship, but also in the definition of a set of recommendations addressed to all professionals, in general, and social policymakers targeting the elderly population in particular. The results from the project have included:
* to identify the factors that increase the risk of exposure of elderly people to different types of abuse and their prevalence;
* to assess their socioeconomic conditions and whether their decline has led to aggressive and abusive behaviour (e.g. physical, verbal, financial abuse, neglect);
* to analyze general health indicators and the extent to which their worsening made old people more vulnerable to violence;
* to characterize the neighbourhood areas of the elderly according to their socioeconomic status and identify the risk factors associated with those areas;
* to assess whether there was a change in the prevalence, dynamics and type of abuse among individuals in the EPIPort cohort who participated in the project.
More specifically, the results show that psychological abuse is the most prevalent in our sample, followed by financial abuse and that women are the main victims of any type of abuse, except financial abuse. Abuses are also prevalent in individuals aged between 70 and 79, in conjugality or cohabitation with other people and/or family members, with high levels of education, who perceive family income as being insufficient, belong to households with food insecurity, have more depressive symptoms and are more negative in assessing their general health. When considering the reduction of household expenses/costs, as well as the alteration of certain circumstances of daily life, due to the economic crisis, the prevalence of abuse increases, which reveals that the economic crisis of recent years significantly increased the risk of exposure of the elderly to abuse. The results also show the existence of effects of accumulation of vulnerability around exposure to abuse. In other words, the great evidence reached with this investigation consists in demonstrating that vulnerability accumulates in what is called disadvantage co-occurrence, which reinforces the importance of social and health policies placing the problem of abuse at the centre of their agendas, taking into account precisely such disadvantages.
Overall, the project has raised important methodological and policy lessons relevant to:
* health and social policymakers who have to take into account the social and health determinants associated with the abuse and neglect of the elderly;
*researchers and research funders: abuse and neglect of the elderly is an area that needs further investigation, both in the family and in an institutional context, and therefore deserves greater attention in terms of funding in order to develop methodological instruments capable of measuring its various dimensions.
The HARMED project has endeavoured to support the potential for impact from the project by ensuring findings are openly accessible in peer-review journal papers, making a report available on the Institute of Public Health (ISPUP) and Institute of Sociology of University of Porto (ISUP), and by carrying out a number of dissemination and outreach activities through conferences, workshops, and other forms of communication (e.g. social media) to share the findings widely. |
