Long-Term Effects of Child Sexual Abuse on Physical Health: A Mixed-Gender, Population-Based Analysis of Older Adults

Despite progress in understanding the effects of child sexual abuse (CSA) on the physical health of survivors, there is a dearth of information about physical health effects in late adulthood. Additionally, analyses that included both men and women have found mixed, contradictory, or inconclusive results. The purpose of this study was to conduct gender-specific analysis of late-life physical health outcomes among adults with histories of CSA. We utilized data from the Wisconsin Longitudinal Study (WLS), a long-term study of a random sample of 10,317 men and women who graduated from Wisconsin high schools in 1957. The study sample included 5,968 respondents from the 2011 survey, when the mean age was 72 years (range: 71-74). We used ordinary least squares (OLS) regression to examine the effect of CSA on the lifetime diagnosed illnesses and self-rated health, controlling for childhood adversities and covariates. To adjust for the count nature of the lifetime diagnosed illnesses variable, we estimated Poisson regression models, which yielded consistent results with the OLS. In this sample, 5.24% (n = 313) of the respondents reported having experienced CSA. In the multivariate analyses, CSA was significantly associated with more lifetime diagnosed illnesses (b = 0.43, p < .001) and poorer self-rated health (b = -0.09, p < .05). The effect of CSA on diagnoses illnesses and on self-rated health did not differ by gender. After more than five decades, CSA was significantly associated with a higher number of lifetime diagnoses and lower self-rated health for individuals in the WLS. Understanding CSA as a life course social determinant of adult health calls for healthcare practices and translational research to promote the health of diverse individuals and populations. Healthcare providers serving older adults should incorporate screening questions and assessments of child maltreatment experiences into routine care.