The article “Social Support, Socio-Economic Status, Health and Abuse among Older People in Seven European Countries” by Melchiorre et al. (2013) explores the intricate relationships between social support, demographic and socio-economic factors, health variables, and elder mistreatment among older adults in Europe. Published in PLoS ONE, this study contributes to a critical area of research, particularly given the lack of comparative studies on elder abuse across multicultural and multinational contexts in Europe.
Background and Purpose: Social support is recognized as having a significant impact on individuals, especially older adults facing health challenges. It is broadly defined as assistance from family, friends, neighbors, and other community members, designed to help individuals cope with daily life and critical situations. A deficiency in social support networks and strained family or social relations can be crucial in later life, increasing vulnerability and serving as risk factors for elder abuse. Conversely, robust social support is theorized to promote well-being, reduce risks for physical and cognitive illnesses, and may act as a protective factor against elder mistreatment. This study aimed to investigate these associations, hypothesizing that high social support would correlate with improved health and well-being, and a reduced risk of mistreatment.
Methodology: This cross-sectional study utilized data collected between January and July 2009, derived from the ABUEL project (“Elder Abuse: A multinational prevalence survey”). The sample comprised 4,467 non-demented individuals aged 60–84 years living in urban centers across seven European countries: Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden. Data was gathered via face-to-face interviews or a combination of interviews and self-response methods. Key variables measured included social support (using the Multidimensional Scale of Perceived Social Support), various types of violence/abuse (psychological, physical, sexual, financial, and injuries), somatic and depressive/anxiety symptoms (using validated scales), health care utilization, and a comprehensive set of demographic and socio-economic indicators. Statistical analyses involved Kruskall-Wallis tests, Spearman correlations, and multivariate quantile linear regression models.
Key Findings: The study identified several factors independently associated with perceived social support:
- Higher social support was linked to being from Greece or Lithuania, being married/cohabiting, divorced/separated, or widowed, living with a spouse/partner or other persons, residing in larger households, frequent use of health care services, and lower scores in depression or physical complaints.
- Lower social support was associated with being from Italy or Portugal, older age (especially 80–84 years), being male, having social/sick-leave/other pension benefits as the main financial support, and exposure to psychological mistreatment.
- Regarding abuse, older people exposed to psychological, physical, or financial abuse, as well as injuries, reported significantly lower total perceived social support. Specifically, psychological abuse was independently associated with decreased social support. While low social support may contribute to a violent emotional context, psychological abuse could also lead to a perception of reduced social support.
Conclusions and Implications: The findings underscore that high levels of social support can serve as a protective factor, effectively reducing the vulnerability of older people and mitigating the risk of elder mistreatment, particularly emotional abuse. The study highlights the complex interplay between social support and various dimensions of later life, demonstrating both cross-country variations and similarities in relational cultural attitudes. Based on these results, the authors suggest that policy makers, clinicians, and researchers should focus on developing intervention programs that foster friendships and social activities in old age, thereby promoting opportunities for social engagement and reducing isolation.
Limitations: The study acknowledges several limitations, including the generalizability of findings due to data being collected only from large urban centers and reliance on self-reports, which may introduce recall bias. The cross-sectional design means that causal links between variables cannot be definitively established, only associations. Furthermore, the relatively low reported numbers for certain types of abuse (e.g., injury and sexual abuse) necessitate caution in interpreting these specific findings and may suggest an under-reporting of abuse. Future research with longitudinal designs is recommended to explore causality and the direction of the observed relationships.
Reference: Melchiorre, M. G., Chiatti, C., Lamura, G., Torres-Gonzales, F., Stankunas, M., Lindert, J., Ioannidi-Kapolou, E., Barros, H., Macassa, G., & Soares, J. F. J. (2013). Social Support, Socio-Economic Status, Health and Abuse among Older People in Seven European Countries. PLoS ONE, 8(1), e54856. https://doi.org/10.1371/journal.pone.0054856.
