Chronic disease and health behaviours linked to experiences of non-consensual sex among women and men.

OBJECTIVES: Few studies have examined the association between non-consensual sex and health indicators for both women and men. The current study examined this relationship as part of a large public health survey that collected information on a range of health behaviours and health risks. METHODS: The Behavioural Risk Factor Surveillance System (BRFSS) is an annual random-digit-dialled telephone survey providing surveillance of health behaviours and health risks among US adults. In 2005, an optional module on sexual violence was available for use at the discretion of each US state/territory. Over 115,000 respondents in 25 states/territories were administered the sexual violence module within the BRFSS. Logistic regression analyses were conducted from January to December 2008. RESULTS: Among both women and men, previous non-consensual sex was associated with health conditions such as high cholesterol, stroke and heart disease, and risk behaviours such as human immunodeficiency virus risk factors, smoking and excessive drinking. Sexually victimized women were more likely to report having had a heart attack or heart disease than non-victims. CONCLUSIONS: The experience of non-consensual sex is associated with a number of chronic disease outcomes and risk factors. The development and implementation of effective sexual violence prevention strategies may reduce the risk of chronic conditions among persons who have experienced sexual victimisation.

Variability of undetermined manner of death classification in the US.

OBJECTIVES: To better understand variations in classification of deaths of undetermined intent among states in the National Violent Death Reporting System (NVDRS). DESIGN: Data from the NVDRS and the National Vital Statistics System were used to compare differences among states. MAIN OUTCOME MEASURES: Percentages of deaths assigned undetermined intent, rates of deaths of undetermined intent, rates of fatal poisonings broken down by cause of death, composition of poison types within the undetermined-intent classification. RESULTS: Three states within NVDRS (Maryland, Massachusetts, and Rhode Island) evidenced increased numbers of deaths of undetermined intent. These same states exhibited high rates of undetermined death and, more specifically, high rates of undetermined poisoning deaths. Further, these three states evidenced correspondingly lower rates of unintentional poisonings. The types of undetermined poisonings present in these states, but not present in other states, are typically the result of a combination of recreational drugs, alcohol, or prescription drugs. CONCLUSIONS: The differing classification among states of many poisoning deaths has implications for the analysis of undetermined deaths within the NVDRS and for the examination of possible/probable suicides contained within the undetermined- or accidental-intent classifications. The NVDRS does not collect information on unintentional poisonings, so in most states data are not collected on these possible/probable suicides. The authors believe this is an opportunity missed to understand the full range of self-harm deaths in the greater detail provided by the NVDRS system. They advocate a broader interpretation of suicide to include the full continuum of deaths resulting from self-harm.