Abstract
Background
Among women in the general population, childhood physical abuse (CPA) is associated
with poor adult health status and engagement in health risk behaviors. Sexual minority
women (SMW) are at elevated risk of CPA, have higher rates of smoking, and may be
at higher risk for poorer general health. In this study, we examined the influences
of CPA on health status in a diverse sample of SMW. We hypothesized that SMW with
a history of CPA would report poorer health than those without such histories and
that early onset of smoking—an important health risk behavior—would mediate the relationship
between CPA and current health status.
Methods
Structural equation modeling was used to evaluate the influence of CPA on early health
risk behavior (i.e., age of smoking onset) and current perceived health status in
a community based sample of 368 SMW.
Results
More than one fifth of the sample (21.5%) reported a history of CPA. One fourth of
the sample was current smokers; the average age of smoking onset was 19 to 20 years
old. The mean level of self-rated health status was between “fair” and “good.” When
relationships were simultaneously estimated, the effect of CPA on health status was
mediated by two sequential smoking factors: CPA was associated with earlier age of
smoking onset, and age of smoking onset was associated with current smoker status.
Being a current smoker had a negative effect on perceived health status.
Implications for Practice and/or Policy
These results suggest that tobacco use is an important pathway by which CPA influences
current health status. Prevention and early intervention initiatives should focus
on the reduction of CPA among SMW to eliminate the long-term health consequences of
adverse childhood events among SMW.
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Biography
Alicia K. Matthews, PhD, is Associate Professor, College of Nursing, University of Illinois at Chicago. Research interests include identification of sociocultural predictors of poor health, and the use of culturally targeted interventions to improve the physical health of underserved minority populations.
Biography
Young Ik Cho, PhD, is Associate Professor, Zilber School of Public Health, University of Wisconsin-Milwaukee. Research interests are: substance abuse behaviors and treatment, substance abuse risk factors among minority populations, and evaluation of substance abuse intervention and treatment programs.
Biography
Tonda L. Hughes, PhD, is Professor, Department Head, Health Systems Sciences, College of Nursing, University of Illinois at Chicago. Research expertise is in sexual minority women's health, alcohol use, and mental health.
Biography
Timothy P. Johnson, PhD, is Professor and Director, Survey Research Laboratory, University of Illinois at Chicago, Chicago. Research interests include cultural disparities in survey measurement and health behaviors among disadvantaged populations.
Biography
Lisa Alvy, MA, is a Doctoral student, Department of Psychology, University of Illinois at Chicago. Research interests include lesbian, gay, bisexual, and transgender (LGBT) health, body image and obesity, and sexual health and HIV prevention.
Article info
Publication history
Published online: February 15, 2013
Accepted:
November 30,
2012
Received in revised form:
October 16,
2012
Received:
March 20,
2012
Footnotes
Supported by National Institute on Alcohol Abuse and Alcoholism grants K01 AA00266 and R01 AA13328 (to Tonda L. Hughes).
Identification
Copyright
© 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
