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Comment & Response
February 2019

Women and Children First: Promoting Empowerment Through Resistance Education—Reply

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
JAMA Intern Med. 2019;179(2):278-279. doi:10.1001/jamainternmed.2018.7813

In Reply We appreciate the comments by McClelland and colleagues on our research1 showing that among midlife women, a history of sexual harassment and/or assault was linked to adverse health outcomes, including hypertension and clinically significant depressed mood, anxiety, and sleep problems. We agree that extending this work to consider childhood abuse and neglect as a predictor of adult health is important. In fact, we have conducted research on this topic2 and found that a history of childhood abuse and neglect was related to greater subclinical cardiovascular disease, a proinflammatory profile, obesity, and metabolic syndrome among women at midlife. These relations persisted when adjusting for important covariates such as race and ethnicity, socioeconomic status, and behavioral risk factors such as smoking and physical activity (Jakubowski and colleages3 provide a meta-analysis).

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