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 non-Indigenous 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%), participants spoke about exposure to violence or a traumatic death of a family member. These included references to close family members who had been murdered or ‘lost,’ gender-based violence, violent attacks, suicide, the death of a young child through medical neglect, and exploitation by a human trafficking ring [
20]. This underscores the need for studies that specifically examine the intersection of indigeneity, violence, and disability [
21‐
24]. However, there continues to be a dearth of quantitative research at this intersection. The current literature indicates that the mechanisms that link indigeneity or disability with violence, intersect and amplify for Indigenous people living with disability [
25].
In this paper, using nationally representative data, we seek to examine several questions about experiences of physical violence and violent threats reported by Aboriginal and Torres Strait Islander people living with disability. Firstly, are Aboriginal and Torres Strait Islander people living with disability more likely to cite incidents of physical violence or violent threats relative to those without disability? Second, does exposure to violence (physical or threatened) differ by type, severity or numbers of disability conditions? Finally, does the relationship between the perpetrator and victim of violence differ between Aboriginal and Torres Strait Islander people with and without disability?
Discussion
Motivated by the ongoing Royal Commission into violence, abuse, neglect and exploitation of people living with a disability, we sought to examine the exposure of Aboriginal people living with disabilities to violence. Our study found that within the Aboriginal and Torres Strait Islander population, presence of a disability was associated with a 1.5 fold increase in the odds of exposure to physical violence, a higher frequency of violence, and doubling of the odds of experiencing threats of violence. These findings are consistent with quantitative evidence showing people with disability and Indigenous people are at much higher risk of experiencing violence than those without disability or non-Indigenous people [
5,
6,
11,
16,
38‐
40].
Qualitative studies have theorised that when the two identities intersect, the systems of disadvantage that Indigenous people and people with disability navigate overlap to greater effect [
25]. In Australia, narrative research on the experiences of Aboriginal and Torres Strait Islander people with disability found that more than a fifth of interviews referenced exposure to violence or a traumatic death of a close family member [
20]. This is despite participants not being asked directly about exposure to violence. The high prevalence of Indigenous family and racially-motivated violence, incarceration, and poverty, in conjunction with the overrepresentation of people with disability in carceral settings and institutions, all work to increase risk of exposure to violence [
21].
This is in addition to other external factors which increase likelihood of remaining in violent situations: disability often being underdiagnosed due to race, Indigenous spaces not having sufficient funding for accessibility measures, and the siloing of organisations into distinct Indigenous and disability-specific services [
8]. The overall high prevalence of violence against people with disability is thought to be the result of lack of economic opportunity which increases the likelihood of living in areas with elevated crime rates and leads to the increased dependence on carers that people with disability experience, in combination with the colonial racism that has led to systemic poverty and trauma [
41]. Cripps and Adams (2014) further conceptualise the factors contributing to family violence in Aboriginal communities into two key factors [
42]. The first are factors attributable to colonisation, including dispossession and cultural dislocation, family removal and policies and practices that continue to impact Aboriginal people, increasing the risk of violence. The second group of factors increasing the risk of family violence in Aboriginal communities relate to those that can occur in any vulnerable population. For example, unemployment and welfare dependency, destructive coping behaviours, mental health issues and past instances of violence or abuse. Evidence also suggests that these latter factors indicative of poor socio-economic outcomes are also experienced by people living with disabilities in the broader Australian population – for example, lower levels of education, employment, housing vulnerability and deleterious financial wellbeing [
43,
44].
The findings from this study that show an elevated risk of experiencing violence based on severity and type of disability are in line with the wider literature regarding levels of violence experienced by people with disability. Severity of disability is strongly associated with all measures of violence. Aboriginal and Torres Strait Islander people with profound or severe disability were at a minimum 2-fold increase in odds of reporting each measure of violence and almost 3 times more likely to be exposed to violent threats compared to Aboriginal and Torres Strait Islander people without a disability. As a further proxy measure of the severity of disability, multiple disability types increased the odds of exposure to violence by approximately 1.4–1.5 times with each successive disability type.
This association is thought to be the result of the contribution of severity of disability to inability to leave violent situations and how that vulnerability contributes to the power dynamics of violence. Those with more severe disabilities are inherently more reliant on carers, thus are more likely to stay in violent carer relationships and be physically unable to escape violent situations [
45,
46]. They also face greater barriers to communicating to authority figures that they have experienced violence, among them being limited verbal communication or not being believed as a result of their disability [
39]. These vulnerabilities make it more likely that a person with violent or controlling intentions seek out people with disability [
47].
Violence was also more pronounced for those living with intellectual disability, psychological disability and/or head injury/stroke/brain damage compared to people with other types of disabilities. In a national-level Danish study, it was also found that people with learning or mental disability were significantly more likely than people with physical disability to experience violence, harassment, or abuse [
33]. A systematic review and meta-analysis of risk of violence against adults with disability found an increased risk for people with intellectual impairments compared to those with non-specific impairments; those with mental illnesses were found to have a higher risk than both other categories [
11]. Similarly, in the UK, the risk of exposure to violent crime was elevated among adult with mental health problems in comparison to both adults with no disability as well as those with other forms of disability [
16]. Interpreting this finding, it is also important to note that disabilities such as those related to head injury may in themselves be caused by a violent event [
48]. Evidence from hospital morbidity data suggests that Aboriginal people, in particular Aboriginal women, are at a significantly increased risk of head injury due to assault [
49].
Family removal, the practise of intentionally taking Indigenous children from their natural family and placing them in other settings, was found in the analysis to be a significant predictor of experiencing violence [
34]. This practise has historically been documented in Australia, Canada, and the USA under the names of the “Stolen Generations”, “Residential Schools”, “the Sixties Scoop”, and “residential boarding schools”, in which the goal was to deny access to Indigenous heritage in order to assimilate Indigenous children into dominant cultures [
34,
36,
50]. It has been theorised both as inherently violent by breaking family ties and connections with community, and as a pathway to experiencing violence in care institutions or foster homes [
51,
52]. Removed children, regardless of disability status, experienced high rates of physical, sexual, and emotional violence in their new care settings [
36]. This was in addition to the constant degradation of their Indigenous identity and attempts to break ties to their culture [
53]. Survivors also report poor housing, food, and educational quality within their care institutions [
51,
52]. Family removal currently manifests in foster or government care processes. It can include efforts to maintain connections to culture and heritage, such as placing children with other Indigenous families, but remains a traumatic experience for children and their families and is experienced at significantly elevated rates by Aboriginal and Torres Strait Islander people [
54].
The impacts of experiencing family removal are wide-reaching and drastic. Survivors of family removal have an increased likelihood of being arrested or being charged with an offence, having alcohol or illicit drug use disorders, cancer, diabetes, heart disease, stroke, back and eye conditions, being unemployed or dependent on government payments, attempted suicide or having suicidal thoughts, worse educational outcomes, cognitive, behavioural or emotional disability, being a victim of violence, loss of parenting skills, living with an infectious disease, or having a mental illness [
7‐
9,
35,
50,
55‐
57]. All of these factors increase barriers to socioeconomic mobility, which in turn, increase the likelihood of living in an area with higher crime [
32]. Lower socio-economic mobility additionally limits the ability to escape violent situations by decreasing financial stability [
32].
We further found that Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report family violence, whereas men were more likely to report violence from other known individuals (i.e., non-partner or familial). The gendered sources of violence have been found in a national analysis of American crime victimisation, in which men were more likely to experience violence from a relative, whereas women were more likely to experience violence from an intimate partner [
17]. The same was true in the Australian setting in a non-Indigenous-specific study [
31]. Women with disability are considered to have a higher risk of experiencing intimate partner or family violence, as compared to men with disability. This is in line with other Australian research on the experiences of Aboriginal and Torres Strait Islander people with disability, where 7 of 9 interviews referencing experiences with violence were with women [
20]. A potential explanatory factor is the socialisation of women with disability to believe that they are uniquely dependent on their partner for long-term care and economic stability, to be compliant, and that they are unable to access caring, loving relationships [
39]. Alternatively, it has been argued that disability further adds to the power disparities and lack of access resources associated with traditional gender roles [
58]. While there is a dearth of methodologically robust studies, it is clear that both gender and type of disability affect the prevalence of violence [
11,
58,
59]. It is critical that strategies to prevent violence are developed taking into account these intersectionalities [
11,
58,
59].
Overall, the findings of this study highlight the intersectionality between Indigeneity and ableism, which in turn has important implications for the design of services for Aboriginal and Torres Strait Islander people. It is an important complement to narrative research aimed at providing a voice to Aboriginal and Torres Strait Islander people with disability to share their unique experiences and their resilience [
20]. National policy for the provision of disability support does include an Indigenous Engagement Strategy; however, the strategy has not been consistently implemented and needs to be considerably strengthened to address the complex needs for Aboriginal and Torres Strait Islander people with disability. This is particularly true in relation to ensuring that disability supports are responsive to the mental and emotional effects of violence, such as trauma or mental illness. Unlike many other sectors (e.g. health, education) there is currently no overarching framework for self-determination, working with Aboriginal and Torres Strait Islander people or cultural safety in the disability sector. This study provides further support to research calling for Aboriginal and Torres Strait Islander people with disability to lead the development of frameworks and approaches for the disability sector [
20].
Study limitations
Our study contains a number of limitations. First, the NATSISS is a cross-sectional survey and we do not make causal inferences about the relationship between the various measures of disability and exposure to violence. Second, the NATSISS operationalises violence as either physical violence or violent threats, omitting specific questions related to sexual assault and sexual threats. Third, the violence measures were collected by self-report over a 1 year period, raising the issue of recall bias. This may lead to an under-estimate of levels of violence which may also exist due to the sensitive nature of the questions. Fourth, as noted earlier, the sampling frame for the NATSISS consisted primarily of people living in private dwellings. Respondents in institutions, for example, were not enumerated in the survey. Finally, Aboriginal people with very severe disabilities may have been under enumerated.
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