Adult Protective Services

In the U.S. we have an abundance of social service systems in place to help those who cannot help themselves. These programs deal with abuse and how one population can be mistreated by another. In this presentation we delve into the specific abuse of the elderly and dependent adult populations. The APS (Adult Protective Services) is a social service system available 24/7 with an in-person response team available in all 58 California counties. Their purpose is to be ready to help when an elderly (person over 65) person or a dependent adult (aged 18-64 requiring assistance for day to day functions) suffer from being unable to meet their own needs, are victims of abuse, neglect or exploitation.

In this PSA we see a woman advocating for the right of everyone- including elderly and dependent adults to be free of abuse. This video speaks to an issue of abuse that is more prevalent in our society than the average person might be aware of.

• Approximately  1 in 10 Americans aged 60+  have experienced some form of  elder abuse . Out of that population only 1 in 14 cases of abuse are reported.
• By 2050, people aged 65 and older are expected to comprise 20% of the total U.S. population
• In 2015, the rate of violent victimization against people with a disability was 2.5 times more than the rate of a person with disability.
• One in 4 U.S. adults – 61 million Americans have disabilities that impact major life activities
• Over 225,000 Californians become victims of this abuse each year.

As you can see, the victims in this study are a huge demographic and need to be protected. The way that our group can help to do this would be contributing to the analysis of data supporting elderly and dependent adult services.

In our story map, using ArcGIS software, my group has mapped out several indicators regarding the cases reported in APS. Our indicators are mapped by county in California using different colors to represent different concentrations of our indicator. Our colors range from a cream to an auburn color showcasing the wide range of results by county. We also used an analytics tool called "Hotspot analysis" from the ArcGIS software to further observe any differences per county. Hotspot analysis is a spatial analysis tool that identifies clusters of spatial phenomena. A hotspot is an area that has higher concentration of events compared to the expected value given a random distribution of events.

In our maps, we used APS (Adult Protective Services) data from August 2017 to August 2018. This data helped us to find any changes related to elderly abuse in the counties of California during these years. Also, we used hotspots to interpret which counties had a higher concentration of elderly abuse. Therefore, the indicators we chose to analyze elderly abuse in our maps are the following: total open cases, reports of alleged abuse received, cases closed, and reports of alleged abuse received after business hours.

All 58 counties in California reported at least two cases in August 2017. From those counties, the six that showed a higher concentration of open cases are Los Angeles, Riverside, Orange, San Bernardino, San Diego, and Ventura. In the map, the bigger circles represent these six counties, and the smaller circles represent the counties that are not significant, meaning they don’t have too many open cases in comparison to the other six. Therefore, around 10% of counties in California have a hotspot with 99% confidence.

For August 2018, the map shows seven bigger circles which represent the counties with higher concentration for total open cases of elderly abuse in California. These counties are Los Angeles, Riverside, Orange, San Bernardino, San Diego, Ventura, and Kern. As you can notice, these are the same counties as the ones in 2017, except for Kern County.

Additionally, we took the percentage change between 2017 and 2018 to see how elderly abuse changed in these places. First, the counties with bigger circles that showed an increase in open cases were Los Angeles with 11.8%, Ventura with 12%, and Orange with 24.3%. Kern County had an increase of 52.9%. For that considerable increase, it was placed with the counties with a higher concentration for 2018 and not in 2017. Then, there was a decrease of open cases in the following places: Riverside with 5.9%, San Bernardino with 3.6%, and San Diego with 1.7%. Although there was a change in these counties, we can conclude that the problem with elderly abuse is placed in Southern California because this area has more open cases in total than the rest of the state.

This map shows how many reports of alleged elderly abuse were received in California in August 2017. The bigger the orange circles, the more cases were received. According to the map, there were more reported cases received in Los Angeles in 2017. The largest orange circle in the city of Los Angeles show us that there were around 3,344 reports abused just in that area in 2017.

This map shows us how many reports of alleged elderly abuse were received in California in August 2018. According to the map, there were more reports received in Los Angeles. The hotspot analysis show that the red area is a hotspot with 99% confidence and the white areas are not significant. There were around 3,339 reports received just in Los Angeles in 2018. In 2018 there were 5 less reports received in Los Angeles, not a drastic change.

These maps show the amount of closed cases in August 2017 to August 2018. By looking at the hot spots, which are the orange circles, we can determine that within the 58 counties in these maps, the counties with the highest amount of closed cases in 2017 and 2018 are San Bernardino, San Diego, Los Angeles and Orange county. The closed cases represent the amount of cases that have been resolved and settled. These counties over the year have had an increase in closed cases especially San Bernardino County with a 12.1% increase. Next is Orange County with a 9.7% increase in closed cases, San Diego with a 7.8% increase and Los Angeles with a 1.7%.

There have been very few counties that have had a decrease in cases, for example, Del Norte County, located in Northern California, has had a decrease of 6% in closed cases. Northern California compared to Southern California has very few to none cases reaching a few hundreds whereas counties in Southern California reach up to a few thousands. Most closed cases are located in Southern California with Los Angeles taking the lead with approximately 3,118 closed cases in 2018. Though by looking at these maps, it may be hard to differentiate any difference between 2017 and 2018 cases, but within Southern California, the 4 counties definitely had an increase in closed cases. 

Abuse can occur at any hour, so to give a full picture of abuse reports received, we chose to include the indicator recording the cases documented after business hours for the month of August in the comparable years of 2017 and 2018. Business hours in this case are defined as hours of typical operation (9-5). APS is a 24/7 responsive service As you can see the cases reported in this indicator have to do relatively with country population. In this case it would be beneficial to look at this map through a "hot spot" perspective to try to see a definitive discrepancy in received case allocation.

This map showing reports after business hours in August 2017 displays the highest concentrated counties of Sacramento, Orange, San Diego, Riverside, Los Angeles. This is true for both maps. As you can see by our orange dot hot spot indicators, we have a cold spot- represented by smaller dots- surrounding the San Francisco area and hot spots around the Los Angeles/SoCal level. This means that hotspot areas are statistically significant of having higher than normal cases for the surrounding area. This result goes hand in hand with the trend of Reports of Alleged Abuse received favoring SoCal as a high concentration with a bit more significance in the NorCal region.

In this map for the reports after business hours in August 2018 we can see that there is not a whole lot of change. The larger more significant orange dots favor the SoCal area with the same five counties being the most concentrated counties. To compare percentage change between the years of 2017 and 2018, I calculated the case number difference. It varies without showing an increasing trend (Figure 1). The calculations for determining the percentage change also don't reflect a certain trend between years 2017 and 2018 (Figure 2).

Using this information, I would assume that that the most populated counties would be those with the highest amount of cases after business hours, however the order of counties with highest population would be Los Angeles, San Diego, Orange, Riverside and San Bernardino (not Sacramento) County. This shows that Sacramento statistically should not be in the top five counties with most abuse cases received after business hours. I also discovered that this issue could use revisiting in the near future due to the top five counties in question for this indicator are set to have 145.45% to 248.22% increase in elder population from the years 2010-2060. Below is the growth trend developed by the California State Plan on Aging 2017-2021 in millions.

Overall, our story map has told us a few things. We have observed that there was not a general increase or decrease of cases from 2017 to 2018 in the most concentrated areas. However, we all seem to have pinpointed our hot spots down to the Southern California region with few outliers. This is significant because it is emphasizing the attention and resources that needs to be dedicated towards the more heavily impacted areas.

This is increasingly essential due to rapidly growing population of those over 60 in the U.S. Those aged 60+ are expected to increase 3 times as fast as the total population-varying by region. This statistic alone raises the importance of pinpointing these areas of high abuse case concentration because it WILL increase over time. We may not have seen a whole lot of change in our data due to the years being back to back, but as Figure 3 shows- the total growth rate of the elderly population will drastically change the composition of California residents.

Aside from being aware of the significance of this data, it is even more important to be aware of how to help individually. An earlier statistic said that 1 in 14 elderly and dependent adult abuse cases go unreported due to fear. In order to erase that fear, more awareness on resources to help should be available. Posters of signs showing loved ones or friends what to look for need to be more accessible. This issue is a pressing one that depends on our state resources such as the A.P.S. to guide the community of those wanting to stop this injustice. This guidance along with an understanding and awareness of a significantly growing population - especially in the SoCal area- will set us on the right path to combat this issue in the future.