Sexual harassment and assault linked to worse physical/mental health among midlife women

A new study by researchers at the University of Pittsburgh School of Medicine suggests that experiences of sexual harassment and sexual assault could have a significant impact on the physical and mental health of midlife women. Study results, published today in JAMA Internal Medicine, also will be presented at the North American Menopause Society meeting on Friday, Oct 5 2018 in San Diego, CA.

"When it comes to sexual harassment or sexual assault, our study shows that lived experiences may have a serious impact on women's health, both mental and physical," said Rebecca Thurston, Ph.D., professor of psychiatry, Pitt School of Medicine and the study's first and senior author. "This is an issue that needs to be tackled with urgency not just in terms of treatment but in terms of prevention."

Sexual harassment and sexual assault are highly prevalent experiences among women. An estimated 40—75 percent of women in the United States have experienced workplace sexual harassment and more than 1 in 3 women have experienced sexual assault. While both have been linked to poorer health outcomes, previous studies have predominantly used self-reported parameters, which could be biased by mood, memory and health literacy, or these studies have not taken into account factors such as socioeconomic status or medication use.

In the current study, Thurston and her colleagues analyzed the association between a history of sexual assault or workplace verbal or physical sexual harassment and physical and mental health parameters such as blood pressure, sleep, mood and anxiety. The analysis was conducted among a group of 304 midlife women between the ages of 40 and 60 who were originally recruited as part of a larger study on association between menopause and cardiovascular health.

In the study group, approximately one in five women reported being either sexually harassed or sexually assaulted. Women who were younger or more financially stressed were more likely to be harassed.

Importantly, the study found that assaulted women were almost three times more likely to have symptoms consistent with major depression and were more than two times more likely to have elevated anxiety. Sexual harassment was associated with higher prevalence of hypertension. Both sexual harassment and sexual assault were associated with a two-fold higher likelihood of poor sleep consistent with clinical insomnia. The associations held true even when demographics, socioeconomic status, medication use and medical history were taken into account. Poor sleep, depression and anxiety are themselves associated with poorer health outcomes, according to the authors.

"We know that sexual harassment and assault are prevalent in our society and can cause significant harm," said Thurston. "If you are a health care provider, recognize that these experiences can have implications for your patient's health. If you are a victim of assault or harassment, don't suffer through it. Get help. If you can, change the situation or remove yourself from it."

Thurston and her colleagues note that the study could be expanded and strengthened by implementing more comprehensive measurement of harassment and assault and increasing the number and diversity of participants.