Analysis of the Influencing Factors of Elderly being Abused and Remaining Silent in China

Analysis of the Influencing Factors of Elderly being Abused and Remaining Silent in China

Jiang Shumin

School of Finance and Public Management, Anhui University of Finance and Economics

DOI: https://doi.org/10.47772/IJRISS.2023.7511

 Received: 17 April 2023;  Accepted: 22 April 2023; Published: 20 May 2023

ABSTRACT:

Under the Confucian culture of “family ugliness must not be exposed”, the elderly in China often choose to be aggrieved/remain silent when facing domestic abuse. Based on the data of the fourth sample survey of urban and rural elderly living conditions in China in 2015 (N=19,940), this study used the Logit model to analyze the influencing factors of the risk of family abuse and the choice of remaining silent of the elderly. The results showed that the annual incidence of domestic abuse among the elderly in China was 5.36%, and the proportion of those who chose to remain silent was 35.77%. The more sons, the higher the risk of domestic abuse in the elderly and whether the elderly choose to remain silent, and the more daughters, the higher the risk of domestic abuse in the elderly, but whether they remain silent is not significant. Overall, it shows that “raising children does not prevent old age”, and to be precise, it cannot prevent the occurrence of elderly abuse.

Key words: elderly abuse; remaining silent; influence factor; China

INTRODUCTION

The global incidence of different forms of abuse in older adults is approximately 10.0% [95% CI: 5.2% to 18.6%] (Ho, Wong et al. 2017). The incidence of elder abuse in the family in China is mainly between 4.9% and 7.0%(Wu Xiaolan and Li Jing 2013, Li Weifeng and Nie Qinghua 2018), which is generally lower than that of other countries. The World Health Organization（2003）defines elder abuse as “conduct that results in one or more acts that cause harm or hardship to older persons in any relationship that should be trusting, or acts in an inappropriate manner that results in harm or hardship for older persons”. Abuse can generally be divided into five types: physical, emotional or psychological, sexual, financial or material, and neglect(Hall, Karch et al. 2016).

At present, the elderly in China are still mainly based on family care, and the most important support in terms of economic support, life care, and spiritual comfort still comes from the family. Data show that 63.2% of the elderly in China receive financial or material support from their children (China Scientific Research Center on Aging, 2019). However, when the elderly need child supports financially, in terms of life care and spirit, if the children do not fulfill their maintenance obligations, it will cause a low quality of life for the elderly, and even constitute domestic abuse. Moreover, elder abuse mostly occurs in the family and occurs in relatively closed life scenes, which makes the evil of abusing the elderly have the characteristics of “behind closed doors”, have strong concealment, and are not easy to be discovered by the outside world. In East Asian culture, “family ugliness must not be exposed”, and many elderly people choose to be aggrieved/remain silent when facing abuse, rather than seeking public measures.

LITERATURE REVIEW

Regarding the academic study of elder abuse, Baker first mentioned the issue of elder abuse in Granny Battering(1975). On the one hand, the analysis of the personal factors of the elderly, such as: gender is an important abuse factor, and female elderly people are more likely to be abused than male elderly people(Kaur,2015;Kosberg,2007;Qian Zhenzhong,2016; LI Chunyan,2014); However, there are also studies that suggest that men have a higher risk of abuse than women(Tatara,1999). This may be related to differences in sample selection and statistical methods. In terms of age, older and younger older adults are more likely to be abused (Qian Zhenzhong,2016;Liao Wanjun,2004).In urban areas, older persons are more vulnerable to economic and psychological abuse, while in rural areas, the incidence of physical abuse is higher(Boorsma,2012;Fowers,2016). Most studies have found that elder abuse is strongly correlated with economic status(Wu Xiaolan,2013;Song Yueping,2015), educational attainment(Archana,2019;Zhu Jiaxing,2017), and physical condition (Wu Li,et al,2012). In general, the gender, age, place of residence, economic capacity and health status of older persons have a significant impact on the occurrence of elder abuse.

On the other hand, researchers analyzed from the factors of caregivers, such as Yang Pingping, Tao Xiuying and others (2013) and showed that the cultural level of caregivers is an important influencing factor of abuse tendency, and the higher the cultural level, the lower the abuse tendency. Nie Qinghua(2018) pointed out in his study that the increased financial burden of family caregivers is an important reason for inducing caregivers to abuse the elderly, and Zhu Jiaxing(2017) also pointed out that economic burden will bring heavier economic pressure to dependents and families, thus becoming a source of violence. Studies have also shown that geriatric physical abuse is strongly associated with drug abuse and alcohol abuse in caregivers (Dong,et al,2012). In addition, the occurrence of old age abuse has a lot to do with changes in family structure, and changes in intergenerational relationships can also affect the occurrence of old age abuse (Wu Jie,et al,2020).It can be seen that the research on caregiver factors is mostly analyzed from the aspects of education level, economic status, mental condition, and history of alcoholism.

Based on these above questions and literature, this paper analyzes the influencing factors of abuse of the elderly in China based on microscopic data, including whether abuse occurs or not, the form of abuse, and whether the elderly choose to remain silent or other public response measures after facing abuse.

DATA AND RESEARCH METHODS

A.Data Sources

The data of this study is based on the data of the fourth sample survey of the living conditions of the elderly in urban and rural areas of China (SSAPUR) in 2015, which was organized from August 1 to 31, and the survey targets Chinese citizens aged 60 and above living in all provinces, autonomous regions and municipalities directly under the Central Government (excluding Hong Kong, Macao and Taiwan) and the Xinjiang Production and Construction Corps, which is nationally representative. The survey method adopts the form of household interview and questionnaire survey, and the survey content focuses on the living conditions of the elderly and the demand for elderly care services. The survey adopts the method of approximating self-weighted samples of “stratified PPS, multi-stage PPS, final stage and other probabilities” for sampling design. The sample size of the survey was 224,360, and the national sampling ratio was about 1.0‰. A further long-form questionnaire conducted by 22,400 people was randomly selected, and on the basis of this paper, the relevant missing variables were removed, and the actual sample analyzed was 19,940 people.

B.Research Methods

This study used cross-sectional data binary logistic regression, with two dependent variables, whether the elderly being abused (“Has your family had abused you since this year?”). The specific abuse is shown in Table 1″) and whether the elderly remaining silent when abuse occurs (“If there is abuse, do you grievance/remain silent?”). Other acts are shown in Table 2″). The model uses the logit regression model, see Equation (1), where the F function is the cumulative standard logistic distribution function.

The independent variable is the number of children. There are two main categories, the number of sons and the number of daughters. The control variables include individual demographic variables, socioeconomic variables, and health variables. Individual demographic variables include demographic variables such as age, sex, marriage, education, rural-urban, regional, rotational support, spouse living together, children living together, and grandchildren living together. Socioeconomic variables include work status (whether or not you have income-earning work such as working as a business or doing business) and economic status (I think that the economic situation belongs to three categories: abundant, basically adequate, and difficult).Health variables included health judgment (three categories: healthy, average, and unhealthy), whether they were disabled[1] and whether they had dementia symptoms[2].

RESULTS

A.Descriptive Statistics

The sample size of this study was 19,940 people, the age range was [60,105] years, the average age was 70.05 (±7.92) years, the proportion of women was 51.8%, the proportion of urban[3] was 53.11%, the proportion of illiterate was 28.56%, the proportion of high school and above was 11.13%, and the proportion of spouses was 72.67%.

Among them, a total of 1,068 elderly people were abused, accounting for 5.36% (see Table 1). Specific to the abuse of the elderly, 0.95% for not providing you with basic living expenses, 0.75% for poor accommodation, 0.12% for not feeding/poorly fed, 0.35% for not seeing a doctor, 0.75% for not taking care of you when you need it, 0.19% for misappropriation of your property, 1.29% for not coming to visit/greet/not talking to you for a long time, 0.23% for frequent scolding, and 0.07% for preventing you from remarrying and other behaviors of 0.15%. After the elderly were abused, 382 of them chose to remain silent, accounting for 35.77% (see Table 2). In contrast, 25.09% chose to seek mediation from relatives/clans, 35.02% sought help from neighborhood committees (village committees), 3.93% sought help from associations for the elderly, 7.40% sought mediation with family units, 2.72% sought litigation/settlement with judicial authorities, 0.56% reported to the media, and 11.14% sought help from other methods.

The results of the cross-analysis are shown in Table 3. In terms of the number of children, the greater the number of sons, the higher the risk of the elderly being abused, and the probability that the elderly choose to remain silent after being abused is also significantly higher. When the number of sons was 0, 1, 2 and 3 or more, the risk of abuse in the elderly in the past year was 3.8%, 4.8%, 6.2% and 6.8%, respectively; The probability of the elderly remaining silent was 18.3%, 30.8%, 40.1% and 46.1%.

Table1  Whether there are various behaviors of abuse in the elderly（N=19,940）

Table2  How older people deal with abuse when faced with abuse（N=1,068）

Table3  Cross statistical table of relevant variables of whether the elderly being abused and remaining silent

Note: The categorical variables are shown as the sample size N(%), and the P value is the significance of Pearson’s chi-square test; Continuous variables are shown as means (standard deviations), and p-values are statistically tested for significance.

B.Regression Results

In the regression results in Table 4, the dependent variable of model (1) is whether there is elder abuse, and the coefficient gives the odds ratio (OR), that is, the odds ratio after change/odds before change. The results showed that the more sons there were and the higher the risk of abuse in older adults, the more sons there were and the OR coefficient was 1.36 (P<0.01), the OR coefficient was 1.56 (P<0.01) for two sons, and 1.48 (P0.01) for three sons or more <0.01).The more daughters, the higher the risk of abuse in older adults. In terms of control variables, the higher the level of education, the cohabitation of spouses and children, etc., the risk of elder abuse is significantly lower; Women in the Western Region, families with financial difficulties, and older adults with dementia are at significantly higher risk of abuse. Variables such as age, presence of a spouse, children in rotation, grandchildren living together, work, self-rated health status, and disability were not significant.

The dependent variable in model (2) is whether the elderly remaining silent after the abuse occurs. The results showed that after controlling for demographic and socioeconomic variables, the more sons the older people chose to remain silent, with an OR coefficient of 2.67 (P<0.01) for one son, 3.73 (P<0.01) for two sons, and 4.45 (P<0.01) for three sons. The number of daughters is less significant. In terms of control variables, the higher the risk of choosing to remain silent among the elderly aged 80 years and older, the western region, family financial difficulties and dementia. The lower the risk that the elderly who take turns to support their children, live together with their children, and have a financially well-off family choose to remain silent.

Table4  Logit model analysis of whether the elderly being abused and remaining silent

Note: a. The model gives the OR coefficient, with Standard errors in parentheses in parentheses, and significance identified as (* p < 0.1, ** p < 0.05, *** p < 0.01).

CONCLUSIONS AND SUGGESTIONS

A.Conclusion

The results of this study show that raising children does not prevent aging, or more precisely, does not prevent the occurrence of elder abuse. And the more sons, the more daughters, the more serious the situation. The possible reason is that there is a two-way causal relationship, assuming that all children have the same feelings for the elderly, and the more children, the higher the overall probability of elder abuse. After abuse occurs, the more sons, the higher the risk that older people will take to remain silent.

However, this paper uses cross-sectional data, and it is inevitable to miss variables (the overall explanatory power of the model is not high), and endogenous problems caused by bidirectional causation. Despite limitations, the results of the study can provide some reference value. In the next step, this paper intends to select more suitable interaction and mediation effect models, as well as latent variable analysis models for more detailed analysis and robustness testing.

B.Suggestions

First, improve the legal system for the protection of the elderly. Jiang Xiangqun and Liu Chunyan (2008) believe that the concept of “elder abuse” should be clearly defined and classified, and at the same time, a comprehensive legal system should be established to increase the punishment of elder abuse. Yang Zhichao (2013) believes that we should learn from the legislative experience of the mandatory reporting system in the United States, establish a mandatory reporting system for elder abuse, and fully play the role of diverse groups to deal with the occurrence of elder abuse. Jin Ting (2013) believes that there are also certain shortcomings in the mandatory reporting system, and it is necessary to establish a regular visiting system, in which police, social workers, community activists, and volunteers conduct regular home visits to examine the living conditions of the elderly to prevent and stop the occurrence of abuse in a timely manner.

Second, improve social support for older persons and caregivers. Wu Fan (2013) believes that the government should formulate family policies that promote intergenerational communication and intergenerational support, strengthen intergenerational emotional communication and life support, so as to reduce communication barriers between the elderly and caregivers and strengthen the relationship between both parties. Wang Ying (2009) believes that the role of informal education for the elderly should be brought into play, a mutual aid platform for social participation should be formed, and mutual assistance and emotional interaction should be carried out. In addition, Jiang Xiangqun (2008) believes that the government should pay attention to supporting the family members of the poor elderly, providing them with financial compensation and policy preferences. Yang Pingping (2015) believes that caregivers should be provided with psychological counseling and legal education.

Third, strengthen filial piety culture and education. Zhu Yunli (2012) believes that filial piety should be integrated into the patriotic education of governments and schools at all levels, and the whole society should pay more attention to and attach importance to the culture of filial piety. Wu Fan (2013) believes that the emphasis on intergenerational communication and exchange in education should be increased, and the educational concept of respecting the elderly should be implemented from childhood. Zhu Wenlong (2015) pointed out that filial piety should be integrated into China’s special rule of law thinking, which not only conforms to the Chinese’s own traditions and public sentiments, but also contributes to the stability and harmony of family relations and the reconstruction of family ethics and morality, and adds luster to the construction of the rule of law and the country with Chinese characteristics.

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FOOTNOTES

[1] The ADL index of daily living ability was used for the self-care ability of the interviewed elderly, and at least one of the six items including eating, dressing, going to the toilet, getting in and out of bed, bathing and walking indoors could not be judged as disabled.

[2] In daily life, I often can’t remember the names of my relatives and friends, I can’t find my home after going out, I often forget to bring my keys, and I often forget that porridge or water is still boiling on the stove.

[3] In the fourth survey, the district where the neighborhood committee is located represents the city, and the area where the village committee is located represents the rural area. According to the statistical urban-rural division code published by the National Bureau of Statistics, the survey area is divided into urban and rural areas. Towns include urban areas, townships and special areas, while the rest of the area is rural.