BackgroundSexual 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.MethodsSecondary 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.ResultsThere 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.ConclusionsStudy 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.
In this case study, we have summarized how we established a cross-sector partnership, agreed on a shared vision of all Kansas children living in safe, stable, nurturing relationships and environments, a shared commitment to reduce the number of children exposed to 3+ ACEs (Adverse Childhood Experiences) to under 10% by 2020, identified six strategies for accomplishing this commitment and organized two workgroups to implement these strategies. As a result, we saw increased dissemination of information on ACEs and use of consistent messaging, changes in partners' organizations, and increased funding for evidence-based programs. With limited resources but considerable enthusiasm, Kansas has made great strides towards changing mindsets about safe, stable, nurturing, relationships and environments and creating a platform for supporting family-friendly policy change.
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