Health care utilization and unhealthy behaviors among victims of sexual assault in Connecticut: results from a population-based sample

Abstract

Background: In the United States, 1 in 6 women report a lifetime prevalence of sexual assault. Few population-based studies have examined the association between sexual assault victimization on health care utilization and unhealthy behaviors.

Objective: To assess the relationship between experiencing sexual assault and health care utilization and unhealthy behaviors among a state-wide representative sample of Connecticut adults.

Design and participants: Cross-sectional study of 4183 Connecticut residents who responded to sexual assault questions in the 2005 telephone-based Connecticut State Behavioral Risk Factor Surveillance System (CT-BRFSS).

Main measures: Health care utilization and unhealthy behaviors among residents reporting sexual assault.

Results: Approximately one out of eleven Connecticut adults (9.4%) experienced sexual assault at some point in their life. Among adults aged 65 years and older, 4.3% reported sexual assault compared to 11.2% of adults aged 18-34 years, (p < 0.001). Among men, 3.7% reported sexual assault victimization versus 14.6% of women, (p < 0.001). After controlling for sociodemographic factors, victims of forced sexual assault were less likely to have seen a physician in the previous 12 months for a routine checkup (Odds ratio [OR]: 1.49, 95%: 1.07-2.07) and more likely to report being unable to see a doctor because of cost (OR: 2.72, 95% CI: 1.70-4.34). Victims were more likely to currently smoke (OR: 2.01, 95% CI: 1.34-3.00) and drink heavily (OR: 3.30, 95% CI: 2.01-5.42) than those reporting no sexual assault.

Conclusions: For Connecticut adults, sexual assault victimization was associated with infrequent usage of some primary care health services and higher risks of unhealthy behaviors. Increased community-level interventions and public health outreach programs are needed to provide health-care services to this high-risk group.

Figure 1

Lifetime prevalence of sexual assault among adults in Connecticut and other states. P-value for comparison generated from Wald-chi square statistics ^† Prevalence from other states describes the prevalence of sexual assault in 19 other states that utilized the BRFSS Module on Sexual Assault in 2005. These states include Arizona, Colorado, Delaware, Florida, Hawaii, Idaho, Mississippi, Missouri, Nevada, Ohio, Oklahoma, Puerto Rico, Rhode Island, South Carolina, Tennessee, Vermont, the U.S. Virgin Islands, Virginia, and Wisconsin.