Physical violence and violent threats reported by Aboriginal and Torres Strait Islander people with a disability: cross sectional evidence from a nationally representative survey

Temple et al. BMC Public Health (2020) 20:1752 https://doi.org/10.1186/s12889-020-09684-4 RESEARCH ARTICLE Open Access Physical violence and violent threats reported by Aboriginal and Torres Strait Islander people with a disability: cross sectional evidence from a nationally representative survey Jeromey B. Temple1* , Heather Wong1, Angeline Ferdinand1, Scott Avery2,3, Yin Paradies4 and Margaret Kelaher1 Abstract Background: A recent Royal Commission into the treatment of Australians living with disabilities has underscored the considerable exposure to violence and harm in this population. Yet, little is known about exposure to violence among Aboriginal and Torres Strait Islander people living with disabilities. The objective of this paper was to examine the prevalence, disability correlates and aspects of violence and threats reported by Aboriginal and Torres Strait Islander people living with disabilities. Methods: Data from the 2014–15 National Aboriginal and Torres Strait Islander Social Survey were used to measure physical violence, violent threats and disability. Multivariable logistic and ordinal logistic regression models adjusted for complex survey design were used to examine the association between measures of disability and exposure to violence and violent threats. Results: In 2014–15, 17% of Aboriginal and Torres Strait Islander people aged 15–64 with disability experienced an instance of physical violence compared with 13% of those with no disability. Approximately 22% of those with a profound or severe disability reported experiencing the threat of physical violence. After adjusting for a comprehensive set of confounding factors and accounting for complex survey design, presence of a disability was associated with a 1.5 odds increase in exposure to physical violence (OR = 1.54 p < 0.001), violence with harm (OR = 1.55 p < 0.001), more frequent experience of violence (OR = 1.55 p < 0.001) and a 2.1 odds increase (OR = 2.13 p < 0.001) in exposure to violent threats. Severity of disability, higher numbers of disabling conditions as well as specific disability types (e.g., psychological or intellectual) were associated with increased odds of both physical violence and threats beyond this level. Independent of these effects, removal from one’s natural family was strongly associated with experiences of physical violence and violent threats. Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report partner or family violence, whereas men were more likely to report violence from other known individuals. (Continued on next page) * Correspondence: 1 Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3053, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Temple et al. BMC Public Health (2020) 20:1752 Page 2 of 12 (Continued from previous page) Conclusion: Aboriginal and Torres Strait Islander people with disability are at heightened risk of physical violence and threats compared to Aboriginal and Torres Strait Islander people without disability, with increased exposure for people with multiple, severe or specific disabilities. Keywords: Violence, Threats, Disability, Aboriginal and Torres Strait Islander Background In 2019, the Australian Government established a Royal Commission into the violence, abuse, neglect and exploitation of people living with a disability. The Royal Commission was charged with investigating, among other questions, the prevention, protection and best practise responses to violence and abuse of people living with a disability. One of the key questions raised in the Commission’s issues paper was “What are the experiences of First Nations people with disability regarding violence, abuse, neglect and exploitation”? [1]. In Australia, the Indigenous population consists of the Aboriginal and Torres Strait Islander peoples. Although estimates vary, Aboriginal peoples are thought to have arrived on the Australian continent at least 50,000 years ago, while the Torres Strait Islanders first settled the islands of the Torres Strait approximately 3000 years ago [2, 3] For many Indigenous peoples worldwide, racism intersecting with colonisation has led to a much higher risk of experiencing violence from both Indigenous and nonIndigenous people across their lifetime [4–6]. In Australia, Aboriginal and Torres Strait Islander people have been subjected to multiple policies of forced removal from land and family, systematic discrimination from education, employment, and services, and currently experience vast inequalities in poverty, health, and overall quality of life outcomes [6–9]. For Indigenous people living with disability, the connection between disability and violence is complex and affected by multiple factors of identity. International studies from the general population show disability and violence are interconnected, as people with disability face increased risk of exposure to violence and experiencing violence can often induce or cause disability [10–13]. This relationship is influenced by the disproportionate poverty and high rates of violence experienced across the life course compared to people without disability, as well as dependence on carers common among people living with disability [14–17]. Exogenously, cultures of silence, encouragement to ignore violence as part of everyday experiences, and imposed norms of helplessness or worthlessness perpetuate cycles of violence [15, 18, 19]. For Indigenous people with disability, racism may intersect with ableism to ultimately create overlapping forms of marginalisation and vulnerability to violence [20]. In Avery’s (2018) study of disability among Aboriginal and Torres Strait Islander people, among 9 of 41 interviews conducted for the research (22%), partici (...truncated)