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

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.

Determining paralysis prevalence in the United States.

BACKGROUND: Estimates of paralysis vary widely, largely owing to a lack of standard definition and nontargeted survey approaches. Like other poorly understood conditions such as fibromyalgia, chronic fatigue, or chronic pain, paralysis falls outside the scope of clearly defined medical diagnosis, further complicating surveillance efforts. This inability to identify accurate prevalence makes developing policy interventions around the needs of many persons with these disabilities problematic. The objectives were to investigate how paralysis is being measured in the United States and to examine the validity of prevalence estimates based on current approaches. METHODS: We reviewed existing measurement instruments and surveyed 139 agencies and organizations to determine how they capture paralysis data. RESULTS: There is a widespread reliance on ICD coding or broad functional capabilities for most state or federal agencies. Many organizations serving consumers depend on state registries for discrete conditions in which paralysis is not directly measured. CONCLUSIONS: Improved paralysis prevalence data will benefit from a more functional definition consistent with ICF guidelines, which can be part of future surveillance efforts at state and federal levels.