Relationships between sexual violence and chronic disease: a cross-sectional study

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Abstract

Background

Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and mental health. Research has demonstrated that individuals who experience sexual assault during childhood are more likely to engage in risky behaviors later in life, such as smoking, alcohol and drug use, and disordered eating habits, which may increase the risk of developing a chronic disease. Despite the high prevalence and economic burden of sexual assault, few studies have investigated the associations between sexual violence and chronic health conditions in the US. The purpose of this study is to identify associations between sexual violence and health risk behaviors, chronic health conditions and mental health conditions utilizing population based data in Kansas.

Methods

Secondary analysis was done using data from the 2011 Kansas Behavioral Risk Factor Surveillance System sexual violence module (N = 4,886). Crude and adjusted prevalence rate ratios were computed to examine associations between sexual assault and health risk behaviors, chronic health conditions and mental health conditions, overall and after adjusting for social demographic characteristics. Additional logistic regression models were implemented to examine the association between sexual assault and health risk behaviors with further adjustment for history of anxiety or depression.

Results

There was a significantly higher prevalence of health risk behaviors (heavy drinking, binge drinking and current smoking), chronic health conditions (disability, and current asthma) and mental health conditions (depression, anxiety, and suicidal ideation) among women who ever experienced sexual assault compared to women who did not, even after adjustment for potential confounders.

Conclusions

Study findings highlight the need for chronic disease prevention services for victims of sexual violence. There are important implications for policies and practices related to primary, secondary, and tertiary prevention, as well as collaborations between sexual violence, chronic disease, and health risk behavior programs.

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Most cited references 40

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Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis.

Laura Chen, M Murad, Molly Paras … (2010)

To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders. We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I(2) statistic was used to assess heterogeneity. The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime diagnosis of anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94), depression (OR, 2.66; 95% CI, 2.14-3.30), eating disorders (OR, 2.72; 95% CI, 2.04-3.63), posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43), sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and suicide attempts (OR, 4.14; 95% CI, 2.98-5.76). Associations persisted regardless of the victim's sex or the age at which abuse occurred. There was no statistically significant association between sexual abuse and a diagnosis of schizophrenia or somatoform disorders. No longitudinal studies that assessed bipolar disorder or obsessive-compulsive disorder were found. Associations between sexual abuse and depression, eating disorders, and posttraumatic stress disorder were strengthened by a history of rape. A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.

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Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses.

H WECHSLER, A. Davenport, G Dowdall … (1994)

To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus. Self-administered survey mailed to a national representative sample of US 4-year college students. One hundred forty US 4-year colleges in 1993. A total of 17,592 college students. Self-reports of drinking behavior, alcohol-related health problems, and other problems. Almost half (44%) of college students responding to the survey were binge drinkers, including almost one fifth (19%) of the students who were frequent binge drinkers. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior than other students. Almost half (47%) of the frequent binge drinkers experienced five or more different drinking-related problems, including injuries and engaging in unplanned sex, since the beginning of the school year. Most binge drinkers do not consider themselves to be problem drinkers and have not sought treatment for an alcohol problem. Binge drinkers create problems for classmates who are not binge drinkers. Students who are not binge drinkers at schools with higher binge rates were more likely than students at schools with lower binge rates to experience problems such as being pushed, hit, or assaulted or experiencing an unwanted sexual advance. Binge drinking is widespread on college campuses. Programs aimed at reducing this problem should focus on frequent binge drinkers, refer them to treatment or educational programs, and emphasize the harm they cause for students who are not binge drinkers.

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Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus.

Eve Van Cauter, A Rydén, Sarah K. Knutson … (2006)

Evidence from laboratory and epidemiologic studies suggests that decreased sleep duration or quality may increase diabetes risk. We examined whether short or poor sleep is associated with glycemic control in African Americans with type 2 diabetes mellitus. We conducted a cross-sectional study of volunteers with type 2 diabetes interviewed at the University of Chicago Hospitals, Chicago, Ill. The final analysis included 161 participants. Glycemic control was assessed by hemoglobin A1c (HbA1c) level obtained from medical charts. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Perceived sleep debt was calculated as the difference between preferred and actual weekday sleep duration. The mean +/- SD sleep duration was 6.0 +/- 1.6 hours, and 71% of the participants were classified as having poor quality sleep (PSQI score >5). We excluded patients with sleep frequently disrupted by pain (n = 39). In patients without diabetic complications, glycemic control was associated with perceived sleep debt but not PSQI score. The predicted increase in HbA1c level for a perceived sleep debt of 3 hours per night was 1.1% above the median. In patients with at least 1 complication, HbA1c level was associated with PSQI score but not perceived sleep debt. The predicted increase in HbA1c level for a 5-point increase in PSQI was 1.9% above the median. In our sample, sleep duration and quality were significant predictors of HbA1c, a key marker of glycemic control. Combined with existing evidence linking sleep loss to increased diabetes risk, these data suggest that optimizing sleep duration and quality should be tested as an intervention to improve glucose control in patients with type 2 diabetes.

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Author and article information

Contributors

Jeanie Santaularia: jsantaularia@kdheks.gov

Monica Johnson: mjohnson5@kumc.edu

Laurie Hart: lhart@kdheks.gov

Lori Haskett: lkaskett@kdheks.gov

Ericka Welsh: ewelsh@kdheks.gov

Babalola Faseru: bfaseru@kumc.edu

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 16 December 2014

Publication date Collection: 2014

Volume: 14

Issue: 1

Electronic Location Identifier: 1286

Affiliations

[ ]Kansas Department of Health and Environment, Bureau of Health Promotion, Topeka, KS USA

[ ]Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, Kansas City, KS 66160 USA

[ ]Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS USA

Article

Publisher ID: 7381

DOI: 10.1186/1471-2458-14-1286

PMC ID: 4302144

PubMed ID: 25516229

SO-VID: 1af76d5b-18bf-401f-a95a-9e792eb4b0e8

License:

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. 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.

History

Date received : 14 July 2014

Date accepted : 8 December 2014

Custom metadata

ScienceOpen disciplines: Public health

Keywords: sexual violence,chronic disease,health risks,behaviors,mental health,brfss

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ScienceOpen disciplines: Public health

Keywords: sexual violence, chronic disease, health risks, behaviors, mental health, brfss

Relationships between sexual violence and chronic disease: a cross-sectional study

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Most cited references 40

Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis.

Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses.

Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus.

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