Prevalence and risk of violence against adults with disabilities

a systematic review and meta-analysis of observational studies

Karen Hughes, Mark A Bellis, Lisa Jones, Sara Wood, Geoff Bates, Lindsay Eckley, Ellie McCoy, Christopher Mikton, Tom Shakespeare, Alana Officer

Research output: Contribution to journalReview article

195 Citations (Scopus)

Abstract

BACKGROUND: About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.

METHODS: In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.

FINDINGS: Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.

INTERPRETATION: Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.

FUNDING: WHO Department of Violence and Injury Prevention and Disability.

Original languageEnglish
Pages (from-to)1621-9
Number of pages9
JournalThe Lancet
Volume379
Issue number9826
DOIs
Publication statusPublished - 28 Apr 2012

Keywords

  • Disabled Persons/statistics & numerical data
  • Humans
  • Mental Disorders/epidemiology
  • Prevalence
  • Risk
  • Violence/statistics & numerical data

Cite this

Prevalence and risk of violence against adults with disabilities : a systematic review and meta-analysis of observational studies. / Hughes, Karen; Bellis, Mark A; Jones, Lisa; Wood, Sara; Bates, Geoff; Eckley, Lindsay; McCoy, Ellie; Mikton, Christopher; Shakespeare, Tom; Officer, Alana.

In: The Lancet, Vol. 379, No. 9826, 28.04.2012, p. 1621-9.

Research output: Contribution to journalReview article

Hughes, K, Bellis, MA, Jones, L, Wood, S, Bates, G, Eckley, L, McCoy, E, Mikton, C, Shakespeare, T & Officer, A 2012, 'Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies', The Lancet, vol. 379, no. 9826, pp. 1621-9. https://doi.org/10.1016/S0140-6736(11)61851-5
Hughes, Karen ; Bellis, Mark A ; Jones, Lisa ; Wood, Sara ; Bates, Geoff ; Eckley, Lindsay ; McCoy, Ellie ; Mikton, Christopher ; Shakespeare, Tom ; Officer, Alana. / Prevalence and risk of violence against adults with disabilities : a systematic review and meta-analysis of observational studies. In: The Lancet. 2012 ; Vol. 379, No. 9826. pp. 1621-9.
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abstract = "BACKGROUND: About 15{\%} of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.METHODS: In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.FINDINGS: Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3{\%} (95{\%} CI 18·3-31·0) in people with mental illnesses, 6·1{\%} (2·5-11·1) in those with intellectual impairments, and 3·2{\%} (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75{\%}). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95{\%} CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.INTERPRETATION: Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.FUNDING: WHO Department of Violence and Injury Prevention and Disability.",
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T1 - Prevalence and risk of violence against adults with disabilities

T2 - a systematic review and meta-analysis of observational studies

AU - Hughes, Karen

AU - Bellis, Mark A

AU - Jones, Lisa

AU - Wood, Sara

AU - Bates, Geoff

AU - Eckley, Lindsay

AU - McCoy, Ellie

AU - Mikton, Christopher

AU - Shakespeare, Tom

AU - Officer, Alana

N1 - Copyright © 2012 Elsevier Ltd. All rights reserved.

PY - 2012/4/28

Y1 - 2012/4/28

N2 - BACKGROUND: About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.METHODS: In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.FINDINGS: Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.INTERPRETATION: Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.FUNDING: WHO Department of Violence and Injury Prevention and Disability.

AB - BACKGROUND: About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.METHODS: In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.FINDINGS: Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.INTERPRETATION: Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.FUNDING: WHO Department of Violence and Injury Prevention and Disability.

KW - Disabled Persons/statistics & numerical data

KW - Humans

KW - Mental Disorders/epidemiology

KW - Prevalence

KW - Risk

KW - Violence/statistics & numerical data

U2 - 10.1016/S0140-6736(11)61851-5

DO - 10.1016/S0140-6736(11)61851-5

M3 - Review article

VL - 379

SP - 1621

EP - 1629

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9826

ER -