Violence against healthcare workers is a political problem and a public health issue: a call to action

Ellen Kuhlmann, Monica Georgiana Brınzac, Katarzyna Czabanowska, Michelle Falkenbach, Marius-Ionut Ungureanu, George Valiotis, Tomas Zapata, Jose M. Martin-Moreno

Violence against healthcare workers (HCWs) strongly increased during the COVID-19 pandemic and this trend seems to con- tinue. The attacks have exacerbated occupational stress and the physical and mental health risks of individual HCWs while also creating new threats for healthcare and societies. The violence has spilled over to social media and the private sphere and created new forms of hate crimes and harassment. Live-threatening physical ag- gression, primarily known from war and conflict settings, now occurs in ordinary workplace settings. International estimations highlight that about every second HCW globally have been affected by vio- lence once in their work lives6 and up to 38% suffer physical violence at some point in their careers.  The frequency and patterns may vary between countries, but violence against HCWs is now also a problem in countries with developed healthcare systems and high levels of trust in institutions and professionals.

The COVID-19 pandemic emerged as a focal point for this violent trend and created new areas of confrontation. The reasons behind the violence are complex and the threats are not limited to HCWs and the workplace. Violence against HCWs is often aimed at the healthcare system and their political representatives and, finally, the democratic state and humanitarian values. Violence seeks to destroy trust in health policy and hamper the right to health for all. Furthermore, it is an attack on democratic states, humanitarian val- ues and civil society.

Systematic monitoring and data are still poor, but the World Health Organization (WHO) and other international organizations and professional associations have taken action. Recently, the ‘Framework guidelines for addressing workplace violence in the health sector’, developed jointly by WHO, International Labour Organization, International Council of Nurses and Public Services International to support the development of violence prevention policies in non-emergency settings and document and research vio- lence in such settings, have become available.1 However, no protective measures and prevention policies have been implemented so far. Most importantly, violence against HCWs is not adequately recognized as a political issue and public health crisis. It is largely absent from health workforce policy and the European and national pandemic recovery plans and debates over health system resilience.

Caregivers facing violence in long‐term care setting: A cross analysis of incident reports and caregivers speech

Marina Blanchard,  Dominique Somme, Kevin Charras, and  Aline Corvol.

The reported frequencies of physical aggression among respondents range from none to daily aggression. Only 76 incident reports were submitted. Aggressions were under‐reported by caregivers who often felt guilty for not having avoided them. Coping strategies included banalization and seeking support from colleagues. Incident reports can constitute a warning signal for the management team but are not a reliable tool for workplace violence follow‐up.

Abuse of older people

The abuse of older people, also known as elder abuse, is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. This type of violence constitutes a violation of human rights and includes physical, sexual, psychological and emotional abuse; financial and material abuse; abandonment; neglect; and serious loss of dignity and respect.

Tackling abuse of older people: five priorities for the United Nations Decade of Healthy Ageing (‎2021–2030)‎

Globally 1 in 6 people aged 60 years and older experience abuse in the community every year. Rates in institutions are even higher. Yet, abuse of older people (also known as elder abuse) remains a low global priority. The UN Decade of Healthy Ageing 2021–2030 offers a unique 10-year opportunity for a step change in how abuse of older people is tackled.

This document outlines five priorities to prevent and respond to abuse of older people:
– combat ageism;
– generate more and better data on prevalence and on risk and protective factors;
– develop and scale up cost–effective solutions;
– make an investment case for addressing the issue; and
– raise funds to tackle the issue.

If governments, United Nations agencies and development organizations, civil society organizations, academic and research institutions and funders implement these priorities, we can reduce the number of older people worldwide who experience abuse and contribute to improving their health, well-being and dignity.

High Prevalence of Elder Abuse During the COVID-19 Pandemic: Risk and Resilience Factors

E-Shien Chang, Becca R Levy

One in five older persons in the study sample (n = 191; 21.3%) reported elder abuse, an increase of 83.6% from prevalence estimates before the pandemic. In the final models, sense of community emerged as a persistent protective factor for elder abuse (odds ratio [OR]: 0.89, 95% confidence interval [CI]: 0.85-0.93). At the relational level, physical distancing was associated with reduced risk of elder abuse (OR: 0.94, 95% CI: 0.90-0.98). At the individual level, financial strain was associated with increased risk of abuse (OR: 1.08, 95% CI: 1.02-1.14).

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