Community characteristics associated with elder abuse

OBJECTIVES: To help define the relationship between elder abuse rates and c ounties' demographics, healthcare resources, and social service characteris tics. DESIGN: County-level data from Iowa were analyzed to test the associa tion between county characteristics and rates of elder abuse between 1984 a nd 1993 using univariate correlation analysis and stagewise linear regressi on. SETTING: Ninety-nine counties in Iowa. PARTICIPANTS: Iowa residents aged 65 years and older. MEASUREMENTS: County-level population-adjusted numbers of abused elderly, a bused children, children in poverty, high school dropouts, physicians and o ther healthcare providers, hospital beds, social workers and caseworkers in the Department of Human Services (DHS). RESULTS: Community characteristics that had a positive association with rat es of reported or substantiated elder abuse at the P <.001 level were popul ation density, children in poverty, and reported child abuse. Lower substan tiated elder abuse rates were associated at P <.05 with higher community ra tes of high school dropouts, number of chiropractors, and number of nurse p ractitioners. After adjusting for number of DHS caseworkers and reported ch ild abuse rates (a surrogate for workload) a district effect persists for s ubstantiated elder abuse cases (P =.002). CONCLUSION: County demographics are risk factors for reported and substanti ated elder abuse. The strongest risk factor for reported elder abuse was re ported child abuse. The difference in districts may reflect differences in resources and/or differing characteristics of caseworkers who substantiate elder abuse. The risk factors may reflect conditions that influence the amo unt of elder abuse or the detection of existing elder abuse.