Studies suggest the need for culturally customized care to interrupt the cycle of violence affecting older minorities

Not enough is being done to prevent elder abuse in the Chinese American community, according to four new Rutgers studies published in the current edition of the Journal of the American Geriatrics Society.

The studies found that a history of abuse, lack of positive social support, and isolation from family significantly increase older Chinese Americans' risk of experiencing elder abuse, chronic health conditions, and even early death. Culturally-sensitive screening for a history of violence among minorities - the key to improving care - remains inadequate, however.

"Violence over the life course has a profoundly negative impact on victims' lives and our society," said lead researcher, XinQi Dong, director of the Rutgers Institute for Health, Health Care Policy and Aging Research and Chair of the National Health Collaborative on Violence and Abuse. "Our research found that violence is prevalent, cumulative and leads to significant adverse health outcomes, including poor physical and mental health, chronic pain, greater use of healthcare services, and increased risk of early death."

Researchers interviewed 3,157 Chinese Americans aged 60 and older and found child abuse, intimate partner violence, negative social support, and isolation from family were potential predictors of elder abuse, including psychological and physical mistreatment, caregiver neglect, and financial exploitation.

According to the studies, 11.4% of study respondents reported experiencing child maltreatment, 6.5% reported intimate partner violence, and 15.2% reported elder abuse. Because traditional cultural values often prevent Chinese older adults from disclosing potential abuse to maintain family harmony, the numbers are likely much higher.

The articles illustrate how various factors contribute to increased risk of elder abuse.

Key findings:

Victims of child abuse are four times likelier to experience intimate partner violence and psychological elder abuse.

Victims of intimate partner violence face five to eight times the risk for psychological elder abuse, six to nine times the risk for physical/sexual abuse, and three times the risk for financial exploitation.

Individuals with a history of childhood physical/sexual abuse are twice as likely to re-experience physical/sexual intimate partner violence. Those with a history of physical/sexual intimate partner violence are at nine times higher the risk of re-experiencing physical/sexual elder abuse.

Family structure is an essential indicator of elder abuse. Older U.S. Chinese immigrants' heavy reliance on family and the stress it can cause increases the risk for elder abuse. Though a tight-knit family can reduce the risk, older adults who receive greater assistance from family are at a higher risk for abuse.

Although evidence shows that positive social support from friends improves well-being, traditional cultural values often prevent older Chinese immigrants from seeking support outside the family, leading to a decreased social circle and, ultimately, increasing the risk of abuse.

All subtypes of elder abuse are associated with a substantially increased risk of 1-, 3-, and 4-year mortality.

The research findings continue to challenge the "model minority myth" - the misperception that the U.S. Asian populations are more economically prosperous, highly educated, have active social and familial relationships, and are healthier than the general population.

"The research has exposed the truth behind the myth," said Dr. Dong. "The truth is that older Chinese Americans are often economically vulnerable, less educated, and suffer from a wide range of health problems exacerbated by the lack of linguistically/culturally sensitive care."

According to Dong, healthcare professionals must work to develop culturally customized services for older minorities.

"Our research suggests that healthcare providers serve a critical role in interrupting the cycle of violence," Dong continued. "To ensure adequate, equitable, and culturally-sensitive care, healthcare providers, must overcome cultural and linguistic barriers to care."

Dong said, by assessing patients for a history of violence, inquiring into family dynamics- focusing on stressors like immigration and acculturation processes - and exploring sources of social support, providers can better screen for elder abuse and, ultimately, improve patients' quality of life.

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About Rutgers Institute for Health, Health Care Policy and Aging Research

Rutgers Institute for Health, Health Care Policy and Aging Research advances health and well-being through meaningful, rigorous and impactful research in the critical areas of behavioral health, health services, health disparities, health policy, health economics, pharmacoepidemiology, and aging research.

Since its 1985 founding, the Institute has become nationally renowned for interdisciplinary and translational research. The Institute's 57,000 square foot facilities are home to six members elected to the National Academy of Medicine and 150 members representing over 30 schools, institutes, and units with adjunct members from 29 national and international universities.