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Original Investigation
October 3, 2018

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

Author Affiliations
  • 1Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 3Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 4Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 5Department of Consultation–Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
  • 6Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 7Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
JAMA Intern Med. Published online October 3, 2018. doi:10.1001/jamainternmed.2018.4886
Key Points

Question  Do women with a history of sexual harassment or sexual assault have higher blood pressure, greater depression and anxiety, and poorer sleep than women without this history?

Findings  Among 304 nonsmoking midlife women recruited from the community to undergo assessment and complete questionnaires for this prospective cohort study, those with a history of workplace sexual harassment had significantly higher odds of hypertension and clinically poor sleep than women without this history, after adjusting for covariates. Women with a history of sexual assault had significantly higher odds of clinically significant depressive symptoms, anxiety, and poor sleep than women without this history, after adjusting for covariates.

Meaning  Sexual harassment and sexual assault have implications for women’s health.

Abstract

Importance  Sexual harassment and sexual assault are prevalent experiences among women. However, their association with health indices is less well understood.

Objective  To investigate the association of history of sexual harassment and sexual assault with blood pressure, mood, anxiety, and sleep among midlife women.

Design, Setting, and Participants  Nonsmoking women without cardiovascular disease were recruited from the community to undergo physical measurements (blood pressure, height, weight), medical history, and questionnaire psychosocial assessments (workplace sexual harassment, sexual assault, depression, anxiety, sleep).

Exposures  Sexual harassment and sexual assault.

Main Outcomes and Measures  Blood pressure, depressive symptoms, anxiety, and sleep characteristics.

Results  Among the 304 nonsmoking women aged 40 to 60 years who participated in the study, all were free of clinical cardiovascular disease, and the mean (SD) age was 54.05 (3.99) years. A total of 19% reported a history of workplace sexual harassment (n = 58), and 22% reported a history of sexual assault (n = 67). Sexual harassment was related to significantly greater odds of stage 1 or 2 hypertension among women not taking antihypertensives (odds ratio [OR], 2.36; 95% CI, 1.10-5.06; P = .03) as well as clinically poor sleep (OR, 1.89; 95% CI, 1.05-3.42; P = .03), after adjusting for covariates. 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), and clinically poor sleep (OR, 2.15; 95% CI, 1.23-3.77; multivariable P = .007), after adjusting for covariates.

Conclusions and Relevance  Sexual harassment and sexual assault are prevalent experiences among midlife women. Sexual harassment was associated with higher blood pressure and poorer sleep. Sexual assault was associated with poorer mental health and sleep. Efforts to improve women’s health should target sexual harassment and assault prevention.

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