Childhood Abuse, Adult Health, and Health Care Utilization: Results from a Representative Community Sample

Abstract

The long-term consequences of childhood abuse on adult mental health have been a major focus of research. Much less attention has been directed to its effects on physical health outcomes. By use of data from the Ontario Health Survey (n = 9,953), the association between retrospective reports of childhood physical and sexual abuse and adult health and health care utilization was examined in men and women. The population health survey was conducted from November 1990 to March 1991 in the Canadian province of Ontario. An association of moderate strength was found between childhood abuse and multiple health problems, poor or fair self-rated health, pain that interferes with activities, disability due to physical health problems, and frequent emergency room and health professional visits but not frequent general practitioner visits. These effects were more pronounced in females and younger respondents. The strength of the associations reported here with odds ratios of 1.3-2.2 was lower than that found between childhood abuse and adult mental health, with odds ratios of 1.9-3.4. Given the growing evidence of the long-term effects of childhood abuse, greater efforts are clearly needed in developing more effective strategies for the prevention and treatment of child abuse.

Childhood sexual abuse and later-life economic consequences

“…However, much of the research on this issue has focused on long-term consequences such as adult mental health, physical health and health care utilization. In this research, CSA has been shown to be associated with psychological disorders such as depression (Molnar, Buka, & Kessler, 2001), post-traumatic stress disorder and anxiety disorder (Chen et al, 2010) and borderline personality disorder (Chartier, Walker, & Naimark, 2007). These negative mental health outcomes have been shown across all age groups.…”

Long-Term Correlates of Childhood Abuse among Adults with Severe Mental Illness: Adult Victimization, Substance Abuse, and HIV Sexual Risk Behavior

“…Among women with SMI, 43-52% report a history of childhood sexual abuse and 33-52% report a history of childhood physical abuse (e.g., Cloitre et al, 1996;Muenzenmaier et al, 1993;Mueser et al, 1998;Rosenberg et al, 2007), compared to 13-32% and 20-21%, respectively, among women in the general population (Briere and Elliot, 2003;Chartier et al, 2007;Edwards et al, 2003;Finkelhor et al, 1990). Many fewer studies have examined the prevalence of childhood abuse among men.…”

Health Care Utilization and Unhealthy Behaviors Among Victims of Sexual Assault in Connecticut: Results from a Population-Based Sample

“…These findings, in conjunction with findings from Chartier et. al., 8 Paranjape et. al., 18 and Henning et.…”

“…4 Recent studies on sexual assault have documented not only the immediate health consequences of the assault, but how injuries and psychosocial stressors experienced during the assault can lead to chronic medical conditions, including smoking, alcohol abuse, chronic pain syndromes, asthma, heart disease, and arthritis among victims. [5][6][7][8][9][10] Few studies, however, have documented the associations between sexual assault and unhealthy behaviors in population-based studies. Additionally, it is unclear how the experience of sexual assault may be associated with health-care utilization trends outside the immediate post-assault time period.…”

“…11 More recent studies described a mixed picture of increased utilization of emergency and urgent care resources and decreased utilization of primary care or routine health services. 8 Furthermore, most studies on the associations between health care utilization and sexual assault use convenience samples derived from emergency rooms, 12,13 HMO populations 3 or clinics and community-based health centers. [14][15][16][17][18] Since sexual assault victims infrequently access health services, population-based studies are needed to examine this phenomenon in more detail.…”