Preventing elder maltreatment: Identification of high risk factors from LTC administrative data

Abstract Elder maltreatment is a serious problem endangering physical, emotional, and material well-being of older persons, especially those with physical and cognitive impairment. However, detecting the incident of elder maltreatment is difficult and its prevalence has been seriously underestimated. This study explores how LTC use relates to elder maltreatment report, using government LTC service records in Taiwan. A total of 88,633 reported cases in adult protection system in 2019 were merged with 443,952 valid cases in LTC service system. Descriptive statistics were firstly performed to examine the proportion and characteristics of repeated cases in both systems. Linear probability modeling was then used for analyses. 1. In 2019, 3,413 elder maltreatment clients can be identified in LTC service system, accounting for 27.3% of the elder maltreatment cases. 2. Older persons who used LTC service first and being reported as elder maltreatment cases later had a higher prevalence of being discovered by social workers and care attendants. 3. These group of clients also had higher proportion of being reported as neglected by others, abandonment, and self-neglected. 4. Characteristics in LTC service system, such as being older, low severity of disability, high cognitive impairments, low income status, and with a LTC service use record, were related to high probability of being detected with elder maltreatment problems. Characteristics in LTC service system could be effective indicators in discovering potentially abusive situations of disabled older persons. Training and education are essential for LTC service providers to enhance their literacy and ability of assessing elder maltreatment.

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Psychological distress during COVID-19 pandemic in low-income and middle-income countries: a cross-sectional study of older persons in Thailand

BMJ Open ◽

10.1136/bmjopen-2020-047650 ◽

2021 ◽

Vol 11 (4) ◽

pp. e047650

Author(s):

Wiraporn Pothisiri ◽

Paolo Miguel Manalang Vicerra

Keyword(s):

Psychological Distress ◽

Low Income ◽

Older Persons ◽

Online Survey ◽

Well Being ◽

Secondary Outcome ◽

Ageing Society ◽

Psychological Well Being ◽

Middle Income ◽

The Impact

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.

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Informal Recyclers’ Health Inequities in Vancouver, BC

NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy ◽

10.1177/1048291118777845 ◽

2018 ◽

Vol 28 (2) ◽

pp. 321-343 ◽

Cited By ~ 4

Author(s):

Josie Wittmer ◽

Kate Parizeau

Keyword(s):

Environmental Health ◽

Social Determinants Of Health ◽

Social Determinants ◽

Low Income ◽

Service Providers ◽

Health Inequities ◽

Well Being ◽

Determinants Of Health ◽

Access To Health ◽

Health Related

We explore informal recyclers’ perceptions and experiences of the social determinants of health in Vancouver, Canada, and investigate the factors that contribute to the environmental health inequities they experience. Based on in-depth interviews with 40 informal recyclers and 7 key informants, we used a social determinants of health framework to detail the health threats that informal recyclers associated with their work and the factors that influenced their access to health-related resources and services. Our analysis reveals that the structural factors influencing environmental health inequities included insufficient government resources for low-income urbanites; the potential for stigma, clientization, and discrimination at some health and social service providers; and the legal marginalization of informal recycling and associated activities. We conclude that Vancouver's informal recyclers experience inequitable access to health-related resources and services, and they are knowledgeable observers of the factors that influence their own health and well-being.

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Finding ‘Reasons to Stay’ Amidst Issues of Well-Being: A Case Study of Two Underserved Communities in Colombo

European Scientific Journal ESJ ◽

10.19044/esj.2020.v16n35p94 ◽

2020 ◽

Vol 16 (35) ◽

Author(s):

Iresha M. Lakshman ◽

Mohideen M. Alikhan ◽

Abdhullah Azam

Keyword(s):

Low Income ◽

Three Dimensional ◽

Well Being ◽

Subjective Well Being ◽

Underserved Communities ◽

Face To Face ◽

Income Status ◽

Supportive Role ◽

The Many ◽

Migration Experiences

This paper attempts to explore the factors that attract and encourage individuals to live in low-income neighbourhoods in Colombo in spite of the many socioeconomic issues that are associated with such communities. Data was collected through 30 face-to-face in-depth interviews with residents from two underserved communities consisting of individuals with different migration experiences. The collected data was then analysed using the three-dimensional well-being model introduced by Pouw and McGregor (2014). The study revealed a situation of material and relational wellbeing intersecting to create a more practical kind of well-being in the communities studied. Of the two, material well-being had the strongest power to attract and retain residents in the neighbourhoods while relational wellbeing played a supportive role in terms of pulling people into the community. Subjective well-being, on the other hand, was identified as the strongest reason with a capacity to push people away from the community. However, this single push factor was not strong enough to overpower the pull effect of material and relational well-being, particularly because of the residents’ low-income status. The material benefits of living in the location facilitated by social ties offered by the neighbourhood kept these residents attracted and attached to these underserved communities.

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Aging, care and dependency in multimorbidity: how relationships affect elderly women’s homecare and health service use

International Journal of Whole Person Care ◽

10.26443/ijwpc.v9i1.331 ◽

2022 ◽

Vol 9 (1) ◽

pp. 31-32

Author(s):

Mohammad Hamiduzzaman ◽

Stacy Torres ◽

Amber JoAnn Fletcher ◽

M Rezaul Islam ◽

Jennene Greenhill

Keyword(s):

Health Services ◽

Peer Relationships ◽

Family Relationships ◽

Service Use ◽

Service Providers ◽

Elderly Women ◽

Elderly Care ◽

Well Being ◽

Building Relationships ◽

And Gender

Relationships are multidimensional, and we know little about the facets of relationships in the way elderly patients’ with multimorbidity utilise homecare and health services. Gerontology literatures emphasize the importance of place of care, inequalities, availability of health services and affordability. However, the diversity of relationships and associated dependency in elderly care remain underassessed. A qualitative study involving a demographic survey and interviews was conducted to explore relationship experiences of elderly women with multimorbidity in homecare and health services utilization. Civil Surgeon of Sylhet District in Bangladesh was contacted to recruit participants for the study, and this resulted in 33 interviews [11 staff and 22 elderly women with multimorbidity]. Three domains of Axel Honneth’s Theory of Recognition and Misrecognition [i.e. intimate, community and legal relationships] were used to underpin the study findings. Data was analysed using critical thematic discourse method. Four themes were emerged: nature of caregiving involved; intimate affairs [marital marginalization, and parent-children-in law dynamics]; alienation in peer-relationships and neighbourhood [siblings’ overlook, neighbourhood challenges, and gender inequality in interactions]; and legal connections [ignorance of rights, and missed communication]. A marginalization in family relationships, together with poor peer supports and a misrecognition from service providers, resulted in a lack of care for elderly women with multimorbidity. Understanding the complexities of elderly women’s relationships may assist in policy making with better attention to their health and well-being support needs. Staff training on building relationships, and counselling services for family and relatives are essential to improve the quality of care for the women.

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The Relationship Between Income Inequality and the Palliative Function of Meritocracy Belief: The Micro- and the Macro-Levels Both Count

Frontiers in Psychology ◽

10.3389/fpsyg.2021.709080 ◽

2021 ◽

Vol 12 ◽

Author(s):

Márton Hadarics ◽

Anna Kende ◽

Zsolt Péter Szabó

Keyword(s):

Low Income ◽

Multilevel Models ◽

Well Being ◽

European Social Survey ◽

Subjective Well Being ◽

Study Program ◽

Income Differences ◽

Country Level ◽

Income Status ◽

The Relationship

In the current paper, we report the analysis of the relationship between meritocracy belief and subjective well-being using two large international databases, the European Social Survey Program (N = 44,387) and the European Values Study Program (N = 51,752), involving data gathered from 36 countries in total. We investigated whether low status individuals are more likely to psychologically benefit from endorsing meritocratic beliefs, and the same benefits are more pronounced in more unequal societies. Since meritocracy belief can function as a justification for income differences, we assumed that the harsher the objective reality is, the higher level of subjective well-being can be maintained by justifying this harsh reality. Therefore, we hypothesized that the palliative function of meritocracy belief is stronger for both low social status (low income) individuals, and for those living in an unequal social environment (in countries with larger income differences). Our multilevel models showed a positive relationship between meritocracy belief and subjective well-being, which relationship was moderated by both individual-level income status and country-level income differences in both studies. Based on these results, we concluded that the emotional payoff of justifying income inequalities is larger if one is more strongly affected by these inequalities.

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Building homes and hopes: the transformative service of YouthBuild Las Vegas

Journal of Services Marketing ◽

10.1108/jsm-03-2020-0098 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Kimberly Nehls

Keyword(s):

High School ◽

Low Income ◽

Service Providers ◽

Las Vegas ◽

Funds Of Knowledge ◽

High School Dropouts ◽

Well Being ◽

Service Research ◽

School Dropouts ◽

Content Type

Purpose YouthBuild programs are uniquely designed to address the status of unemployed and uneducated young men and women who are disconnected from work and education. This study, on YouthBuild Las Vegas (YBLV), aims to fill the call for more research on transformative service research, specifically related to education, poverty and well-being. The program educates “opportunity youth” in construction skills while also encouraging progression toward a GED/HiSet or high school diploma. Service providers can better understand how to increase and support reconnection and well-being, especially among low-income individuals in communities with great needs for support services. Design/methodology/approach This yearlong qualitative research study intended to better understand transformative service within the context of former high school dropouts previously without a path to a productive future. YBLV was an ideal single-site case study because it was bound by space, people, organization and time. The study followed one YBLV class from admission through graduation; the qualitative work with the organization started prior to the students’ enrollment and continued after the students graduated. Primary data collections were interviews and observations. Additional data collection occurred in the forms of written documents, as well as photos and videos. Findings YBLV succeeded because of service providers’ attention to the funds of knowledge of the student population and adapting the format and structure of programs to adult learners, developing mentors for consumers and acknowledging the context and layers of knowledge that consumers brought to the program. The students were able to experience reconnection and increased well-being because of the service providers’ impact throughout the program. Research limitations/implications Transformative service research (TSR) research has focused on areas as diverse as health care and homelessness, whereas the lens of funds of knowledge has primarily been applied within educational settings. It would be worthwhile to apply funds of knowledge framework beyond education yet still within the TSR agenda. There are also opportunities to apply the theory to other vulnerable populations. Broadening the scope of reconnection and well-being TSR research far beyond YouthBuild may identify additional or other synergies between these areas. Practical implications The growing body of research on TSR suggested a gap in understanding how service providers can support consumers in poverty and a need for greater well-being. This study on YouthBuild highlighted the phenomenon among low-income, undereducated, urban young adults and while the goal of qualitative research is not to be generalizable, specific examples such as adapting programs and structures to low-income consumers, developing mentors to model wanted behavior and goal-setting and acknowledging the funds of knowledge that consumers bring to situations, can be generic ingredients for future transformative service projects. Social implications Research has demonstrated that public investment in programs that assist youth toward a positive trajectory and greater well-being is much more beneficial than disciplinary measures such as increased spending on policing and prisons. Employment and educational training programs have led to measurable success and when disconnected youth have greater vocational training and high school completion, they and the broader economy experience improved outcomes. Therefore, from a policy perspective, YouthBuild and programs like it emphasize growth, development and well-being for undereducated and low-income individuals. Originality/value The funds of knowledge theoretical framework are new to the Journal of Services Marketing (JSM). That framework coupled with the population of former high school dropouts in a second-chance school and a focus on service providers and well-being within a poverty context, all contribute to the paper’s originality. Reconnection is also a relatively new concept for readers of JSM. These three areas: funds of knowledge, reconnection and TSR are the backbone of this research.

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Rethinking Service Systems and Public Policy: A Transformative Refugee Service Experience Framework

Journal of Public Policy & Marketing ◽

10.1177/0743915620962815 ◽

2020 ◽

pp. 074391562096281

Author(s):

Silke Boenigk ◽

Raymond Fisk ◽

Sertan Kabadayi ◽

Linda Alkire ◽

Lilliemay Cheung ◽

...

Keyword(s):

Public Policy ◽

Nonprofit Organizations ◽

Service Providers ◽

Service System ◽

Well Being ◽

Research Literature ◽

Service Systems ◽

Policy Makers ◽

Service Experience ◽

Research Questions

The global refugee crisis is a complex humanitarian problem. Service researchers can assist in solving this crisis because refugees are immersed in complex human service systems. Drawing on marketing, sociology, transformative service, and consumer research literature, this study develops a Transformative Refugee Service Experience Framework to enable researchers, service actors, and public policy makers to navigate the challenges faced throughout a refugee’s service journey. The primary dimensions of this framework encompass the spectrum from hostile to hospitable refugee service systems and the resulting suffering or well-being in refugees’ experiences. The authors conceptualize this at three refugee service journey phases (entry, transition, and exit) and at three refugee service system levels (macro, meso, and micro) of analysis. The framework is supported by brief examples from a range of service-related refugee contexts as well as a Web Appendix with additional cases. Moreover, the authors derive a comprehensive research agenda from the framework, with detailed research questions for public policy and (service) marketing researchers. Managerial directions are provided to increase awareness of refugee service problems; stimulate productive interactions; and improve collaboration among public and nonprofit organizations, private service providers, and refugees. Finally, this work provides a vision for creating hospitable refugee service systems.

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Long-term and late effects (LLEs), anxiety, and depression among long-term survivors of pediatric, adolescent, and young adult (P-AYA) cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.143 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 143-143

Author(s):

Linda A. Jacobs ◽

Abigail N. Blauch ◽

Donna A. Pucci ◽

Steven C Palmer

Keyword(s):

Body Image ◽

Low Income ◽

Depression Scale ◽

Psychosocial Outcomes ◽

Well Being ◽

Anxiety And Depression ◽

Psychological Well Being ◽

Income Status ◽

Body Image Concerns

143 Background: Adult P-AYA cancer survivors report numerous LLEs, as well as potential decrements in psychological well-being. The relationship between LLEs and psychological well-being, however, has not been well described in this population. We examined this relationship and predictors of LLEs and well-being in a sample of adult survivors of P-AYA cancer. Methods: Survivors of P-AYA cancer > 2 years from end of treatment completed the Hospital Anxiety and Depression Scale (HADS) and a measure of presence and severity of 11 common LLEs following a survivorship visit. LLEs included fatigue, pain, insomnia, numbness, joint or muscle pain, difficulties with concentration or memory, body image concerns, decreased sexual interest, and weight. Results: Participants (N = 237) were predominately white (89%), college educated (76%), single (63%), and had an annual income of > $60,000 (69%). A plurality had diagnoses of leukemia (30%) or Hodgkin's lymphoma (29%) treated 17 years previously. Treatment included surgery (35%), chemotherapy (91%), XRT (59%), and BMT (17%). Anxiety (M = 6.02; SD = 3.07) and depression (M = 2.54; SD = 2.85) scores were generally low and below the cutpoint of 8 (all t < -7.8; all p < .001 ), although 21% and 9% screened positively for anxiety or depression, respectively. 91% of participants reported at least 1 LLE (M = 4.8, SD = 3.1), most commonly fatigue (73%), concentration (57%) and memory difficulties (53%), and body image problems (48%). Total number LLEs was associated with elevations in both anxiety and depression, as was severity for each individual LLE (all p < 0.001). Only one LLE, difficulty with body image, produced large effects for both anxiety and depression. Low income status were associated with both LLEs and elevations in anxiety and depression (all p < 0.01). Conclusions: Most P-AYA survivors report LLEs. Although anxiety and depression are modest, elevations occur in a substantial number of survivors. Presence of LLEs is associated with worse psychosocial outcomes, particularly difficulties with body image. Lower income individuals and those with body image concerns may be at particular risk of poorer psychosocial outcomes.

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Association Between Medicaid Coverage and Income Status on Health Care Use and Costs Among Hypertensive Adults After Enactment of the Affordable Care Act

American Journal of Hypertension ◽

10.1093/ajh/hpz101 ◽

2019 ◽

Vol 32 (10) ◽

pp. 1030-1038 ◽

Cited By ~ 2

Author(s):

Donglan Zhang ◽

Matthew R Ritchey ◽

Chanhyun Park ◽

Jason Li ◽

John Chapel ◽

...

Keyword(s):

Health Care ◽

Affordable Care Act ◽

Low Income ◽

Service Use ◽

Care Service ◽

Health Care Service ◽

Medical Expenditure ◽

Medicaid Coverage ◽

Income Status ◽

Health Care Service Use

Abstract Background Hypertension is highly prevalent among the low-income population in the United States. This study assessed the association between Medicaid coverage and health care service use and costs among hypertensive adults following the enactment of the Patient Protection and Affordable Care Act (ACA), by income status level. Methods A nationally representative sample of 2,866 nonpregnant hypertensive individuals aged 18–64 years with income up to 138% of the federal poverty level (FPL) were selected from the 2014 and 2015 Medical Expenditure Panel Survey. Regression analyses were performed to examine the association of Medicaid coverage with outpatient (outpatient visits and prescription medication fills), emergency, and acute health care service use and costs among those potentially eligible for Medicaid by income status—the very low-income (FPL ≤ 100%) and the moderately low-income (100% > FPL ≤ 138%). Results Among the study population, 70.1% were very low-income and 29.9% were moderately low-income. Full-year Medicaid coverage was higher among the very low-income group (41.0%) compared with those moderately low-income (29.1%). For both income groups, having full-year Medicaid coverage was associated with increased health care service use and higher overall annual medical costs ($13,085 compared with $7,582 without Medicaid); costs were highest among moderately low-income patients ($17,639). Conclusion Low-income individuals with hypertension, who were potentially newly eligible for Medicaid under the ACA may benefit from expanded Medicaid coverage by improving their access to outpatient services that can support chronic disease management. However, to realize decreases in medical expenditures, efforts to decrease their use of emergency and acute care services are likely needed.

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Patterns of individual coping, engagement with social supports and use of formal services among a five-country sample of resilient youth

Global Mental Health ◽

10.1017/gmh.2015.19 ◽

2015 ◽

Vol 2 ◽

Cited By ~ 10

Author(s):

M. Ungar ◽

L. Theron ◽

L. Liebenberg ◽

Guo-Xiu Tian ◽

A. Restrepo ◽

...

Keyword(s):

Coping Strategies ◽

Service Use ◽

Service Providers ◽

Social Supports ◽

Well Being ◽

Substantive Theory ◽

Formal Service ◽

Full Dataset ◽

Formal Services ◽

Individual Capacity

Background.Although resilience among victims of child abuse is commonly understood as a process of interaction between individuals and their environments, there have been very few studies of how children's individual coping strategies, social supports and formal services combine to promote well-being.Method.For this study, we conducted a multi-phase analysis of a qualitative dataset of 608 interviews with young people from five countries using grounded theory strategies to build a substantive theory of young people's service and support use patterns. We started with an analysis of ten interviews (two from each country) and then compared these findings to patterns found in each country's full dataset.Results.The substantive theory that emerged explains young people's transience between individual coping strategies (cognitive and behavioral), reliance on social supports (family members, peers and teachers), and engagement with formal service providers whose roles are to provide interventions and case management. Young people's patterns of navigation were shown to be contingent upon the individual's risk exposure, his or her individual capacity to cope, and the quality of the formal and informal supports and services that are available and accessible.Conclusion.Differing amounts of formal resources in low-, middle- and high-income countries influence patterns of service use. Implications for better coordination between formal mental health services and social supports are discussed.

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