Cognitive impairment and exploitation: connecting fragments of a bigger picture through data

Abubakar, Aisha M; Seymour, Rowland G; Gardner, Alison; Lambert, Imogen; Fyson, Rachel; Wright, Nicola

Abstract

Background
Exploitation poses a significant public health concern. This paper highlights ‘jigsaw pieces’ of statistical evidence, indicating cognitive impairment as a pre- or co-existing factor in exploitation.

Methods
We reviewed English Safeguarding Adults Collection (SAC) data and Safeguarding Adults Reviews (SARs) from 2017 to 22. Data relevant to exploitation and cognitive impairment were analysed using summary statistics and ‘analysis of variance’.

Results
Despite estimates suggesting cognitive impairments may be prevalent among people experiencing exploitation in England, national datasets miss opportunities to illuminate this issue. Although SAC data include statistics on support needs and various forms of abuse and exploitation, they lack intersectional data. Significant regional variations in recorded safeguarding investigations and potential conflation between abuse and exploitation also suggest data inconsistencies. Increased safeguarding investigations for people who were not previously in contact with services indicate that adults may be ‘slipping through the net’. SARs, although representing serious cases, provide stronger evidence linking cognitive impairment with risks of exploitation.

Conclusions
This study identifies opportunities to collect detailed information on cognitive impairment and exploitation. The extremely limited quantitative evidence-base could be enhanced using existing data channels to build a more robust picture, as well as improve prevention, identification and response efforts for ‘at-risk’ adults.

Citation

Abubakar, A. M., Seymour, R. G., Gardner, A., Lambert, I., Fyson, R., & Wright, N. (2024). Cognitive impairment and exploitation: connecting fragments of a bigger picture through data. Journal of Public Health, Article fdae266. https://doi.org/10.1093/pubmed/fdae266

• Journal Article Type: Article
• Acceptance Date: Sep 13, 2024
• Online Publication Date: Oct 2, 2024
• Publication Date: Oct 2, 2024
• Deposit Date: Oct 10, 2024
• Publicly Available Date: Oct 10, 2024
• Journal: Journal of Public Health
• Print ISSN: 1741-3842
• Electronic ISSN: 1741-3850
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Article Number: fdae266
• DOI: https://doi.org/10.1093/pubmed/fdae266
• Keywords: disabilities, safeguarding, modern slavery, exploitation, cognitive impairment, learning, adults, mental health, services, England
• Public URL: https://nottingham-repository.worktribe.com/output/40290582
• Publisher URL: https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdae266/7808369