Elder Abuse:
Community Advocacy to Health Policy
XinQi Dong, M.D., M.P.H.
APSA Congressional Policy Fellow/Health and Aging Policy Fellow
Associate Professor of Internal Medicine, Behavioral Sciences and Nursing
Rush University Medical Center
Historical Development –
Patriarchal Roots
• Doctrine of Covertures- women loses separate
legal identify once married
• Husbands both obligated and permitted to
“chastise” wife and children to maintain
discipline
• “a husband is responsible for the acts of his wife,
and he is required to govern his household, and
for that purpose, the law permits him to use
towards his wife such a degree of force, as is
necessary to control on unruly temper, and
make her behave herself”
State vs. Black, 60 N.C. 262 (1864)
Doctrine of Family Privacy
• “We will no more interfere when the
husband whips the wife, than where the
wife whips the husband…We will not
inflict upon society the greater evil of
raising the curtain upon domestic privacy,
to punish the lesser evil of trifling
violence”
State v Rhodes, 61 N.C. 453 (1868)
Burston GR. BMJ 1975:iii
Epidemiology
• 2 Million Cases/yr Annually in the US
• Prevalence 3 - 25% : Incidence 2.6 – 15%
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Depends on Age (60 or 65)
Depends on Definition
Depends on Population Sample
Depends on Racial/Ethnic Subgroups
Depends on Survey Methodology
• 1 out of 14 Cases are Elder Abuse Reported
• 1 out of 25 Cases of Financial Exploitation
Reported
Iceberg Principle:
Citywide Partnership
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Dept of Buildings
Dept of Public Health
Dept of Streets and Sanitation
Dept of Water Management
Department of Human Services
Police Department
Cook County State Attorney
Cable Company: Comcast
Phone Company: SBC
Libraries
Blue Cross
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Fire Department
Housing Authority
CAPS
Illinois Department of Aging
Rush Medical Center
Chicago Land Hospital
People’s Energy
Com Ed
Animal Control
U.S. Postal Services
Many other faith-based and
community based organization
50,000 Field Workers Trained
US Chinese History:
• 1830 First Census: Chinese: 3
• 1840-50’s Series of natural
disasters in China
• Settlers in CA, OR & WA
• Indentured Servitude: men
• Transcontinental Railroad
80% Chinese
• 1869 Last Railroad Track
Sinophobia:
• Anti-Chinese Sentiment Along Pacific's
• 1859: Racial Segregation
– SF public schools prohibit Chinese children
from attending schools with White children.
• Prejudice Intensified in 1861
• Anti-Chinese Riots in SF and LA
• 1863 People vs. Hall
– CA supreme court law forbid Chinese to
testify against white men in court
Chinese Exclusion Act: 1882
• Barred Chinese
Immigration to US
• Prohibited Chinese
From Obtaining
Citizenship
• In Act till 1943
Anti-Chinese Violence:
• The LA Chinese Massacre of 1871
• The WY Rock Spring Massacre of 1885
• United States v. Wong Kim Ark, 1898
Migration Toward East:
Community Participation
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Chinese American Service League
Chinatown Senior Housing
Chinese Pine Tree Council
Chinatown Chamber of Commerce
Asian Health Coalition of Illinois
Chinese Museum Foundation
Chinatown Senior Housing
Xi Lin Community Center
Asian American Institute
Pui Tak Center
Chicago Chinese Cultural Institute
Midwest Asian Health Association
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Chinese American Civic Council
Illinois Coalition for Asian Health
Chinese Mutual Aid Association
Chicago Department of Public Health
Illinois Department of Public Health
Illinois Department on Aging
Chicago Department on Aging
Danny Solis. Alderman
Danny Davis. Congress
Richard Durbin. Senate
Community Advisory Board Members
Community Residents
Breaking the Barriers:
• Helping Hands Program
• Saturday with Seniors!
• Tai-Chi
• Calligraphy
• Chinese Poetry
• Water Painting
• Photo Journalism
News Column:
Build Research InfrAstructure &
Network in Chicago CHinatown:
(BRANCH Project)
Research Advocacy:
• Messaging
– The crux of the matter
– The reasons why anyone should care about
your research, study, initiatives, or
annoucement
– Help frame a broad issue and generate
support for change
– A good message is: clear, compelling,
accurate, and short
Health Policy:
• Health Care Reform
• Elder Justice Act
• Elder Abuse Victims Act
• Older American’s Act
• Violence Against Women Act
Maslow’s Hierarchy of Needs
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Elder Abuse Quotations - The Institute on Medicine as a Profession