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Grand Rounds

Long term effects of Sexual Harassment and Assault on Both Mental and Physical Health

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BACKGROUND AND PURPOSE:

  • There is data on the connection between sexual harassment and assault and women’s health
    • Usually self-reported, survey studies may not be appropriately validated
    • Potential for confounding (e.g. due to healthcare access)
  • Using a well-characterized sample, Thurston et al. ( JAMA, 2018) sought to determine whether a history of sexual harassment and sexual assault was associated with blood pressure, mood, anxiety, and sleep among midlife women

METHODS:

  • Cohort Study
    • Recruited from the community
    • Originally selected for a research study association between hot flashes and subclinical atherosclerosis
  • Women were surveyed and provided
    • Physical measurements (blood pressure, height, weight)
    • Medical history
    • Questionnaire psychosocial assessments (workplace sexual harassment, sexual assault, depression, anxiety, sleep)
  • Primary outcomes
    • Blood pressure
    • Depressive symptoms
    • Anxiety
    • Sleep characteristics

RESULTS:

  • 304 nonsmoking women aged 40 to 60 years were included
    • All were free of clinical cardiovascular disease
    • Mean (SD) age: 54.05 (3.99) years
    • 19% reported a history of workplace sexual harassment
    • 22% reported a history of sexual assault
  • Sexual harassment was related to significantly greater odds of
    • Stage 1 or 2 hypertension among women not taking anti-hypertensives
      • Odds ratio [OR] 2.36; 95% CI, 1.10-5.06 (P = .03)
    • Clinically poor sleep
      • OR 1.89; 95% CI, 1.05-3.42 (P = .03)
    • Sexual assault was associated with significantly greater odds of
      • Clinically elevated depressive symptoms
        • OR 2.86; 95% CI, 1.42-5.77 (multivariable P = .003)
      • Clinically relevant anxiety
        • OR 2.26; 95% CI, 1.26-4.06 (P = .006)
      • Clinically poor sleep
        • OR 2.15; 95% CI, 1.23-3.77 (multivariable P = .007)

CONCLUSION:

  • While the approximately 20% rate of sexual harassment or assault is high, it is lower than many national samples
  • Using full, validated scales with adjustment for confounders, sexual harassment was associated with higher blood pressure and poorer sleep. Sexual assault was associated with poorer mental health and sleep
  • The authors state

Given the high prevalence of sexual harassment and assault, addressing these prevalent and potent social exposures may be critical to promoting health and preventing disease in women.

Learn More – Primary Sources:

Association of Sexual Harassment and Sexual Assault With Midlife Women’s Mental and Physical Health

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Related ObG Topics:

Screening for Sexual Assault
Medical Evaluation of the Rape Victim
Emergency Contraception: What, When and How?

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