About the research
The recent World Report on Disability highlighted violence as a leading cause of death among disabled people, but little is known about the prevalence of violence in this vulnerable group nor the associated societal costs of such attacks.
This research draws on data from the Crime Survey for England and Wales to understand whether people with disability are at a greater risk of violence than those without disability – and if people with mental illness have a greater risk than those with physical or other disabilities. It also attempts to answer whether disabled victims experience more severe health problems following violence than non-disabled victims. In addition, the researchers aim to calculate the proportion of violence victimisation that is attributable to disability and the associated economic cost.
In short, the findings indicate that people with disability are at higher risk of domestic and non-domestic violence, and subsequent mental illness, than those without disability, with a high public health and economic burden. It was estimated that if the risks for those with disability were similar to those without, there would have been 116,000 fewer disabled victims of violence in England and Wales in 2009 (with an estimated saving of £1.51 billion).
The researchers point out that future studies need to trial public health and legal interventions to reduce the risk of victimisation and meet the needs of disabled victims. This could direct policy focus on the unique needs of this vulnerable group.
Methodology
The analysis is based on a process of merging the datasets from the Crime Survey of England and Wales, including interpersonal violence, drug use and drinking behaviour modules. The main survey used face-to-face interviews, and included measures of non-domestic and domestic physical and sexual violence. Sexual assaults and domestic violence were also measured using a more sensitive self-completion questionnaire, but only in those aged 16 to 59.
Two sets of analyses were performed:
- an analysis of data on all participants, using violence measures from face-to-face interviews only
- an analysis of data on the subgroup of people aged 16 to 59 who answered the self-completion questionnaire, using both face-to-face and self-completion violence measures. The former included all participants across the age range, whilst the latter included a younger subgroup with more sensitive measures of sexual and domestic violence.
The study’s main exposure was a three-level disability measure:
- no disability
- one or more disabilities, including disability due to mental illness
- one or more disabilities, excluding disability due to mental illness
The main outcome was being the victim of any actual or threatened violence in the past year (whether physical or sexual, domestic or non-domestic). Secondary outcomes were the following six violence subtypes: actual, threatened, physical, sexual, domestic, and non-domestic violence.
Finally, design-based analyses were carried out which took into account the complex survey design, including weighting, clustering and stratification. Weighted prevalence estimates are reported with robust standard errors. Hypothesis tests were based on adjusted Pearson’s tests (for bivariate analyses), or adjusted Wald tests (for multivariate logistic regression analyses).
Publications
This research was featured in the following academic journal and media:
Khalifeh, H., Howard, L.M., Osborn, D., Moran, P. and Johnson, S. (2013) ‘Violence against people with disability in England and Wales: Findings from a national cross-sectional survey” PLOS ONE 8(2): e55952. doi:10.1371/journal.pone.0055952 Retrieved 28 August 2013 from http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055952
There is also ongoing work through the Mental Health and Justice Project, led by Victim Support in partnership the Institute of Psychiatry at King’s College London and University College London and other partners. This project aims to investigate crime victimisation among people with mental health problems, along with the barriers to accessing justice among this group.