Sunday, February 7, 2016

Thinking beyond Penn State . . . sexual abuse kills

Far beyond State College, people say they are far more likely to confront a drunk driver than someone who is abusing a child. Perhaps they don't realize that abuse can also cause death, just more slowly.

Thinking beyond Penn State . . . sexual abuse kills

The ACE Pyramid shows how traumatic childhood experiences appear  to build through a lifetime.
The ACE Pyramid shows how traumatic childhood experiences appear to build through a lifetime.

There has been a lot of talk about why those at Pennsylvania State University did not report suspicions of child sexual abuse to authorities, much of it focused on the unique culture of the college football monolith. But the reluctance to report child sexual abuse is not a phenomenon exclusive to State College, research from the Centers for Disease Control and Prevention suggests.

In 1995, Vermont residents were surveyed about their perceptions of child sexual abuse as a public-health problem. While 75 percent of respondents said they would confront someone who was about to drive drunk, a mere 9 percent said they would directly confront a sexual abuser. And only 65 percent of respondents said they would report the abuse to local authorities.

Why is it that people would take decisive action to prevent drunken driving but not the sexual abuse of a child?

Perhaps it is because few people really understand the devastating consequences of sexual abuse.

The Adverse Childhood Experiences (ACE) Study, described in an earlier series of posts, found that adults who were sexually abused as children were more than three times as likely to attempt suicide as those who weren’t. The research also found that the severity of the sexual abuse mattered, with suicide risk being higher among those who had sexual intercourse during the abuse.

A study of adult women determined that those who were sexually abused as children reported significantly more physical ailments (such as migraines, muscle aches, diarrhea, and vomiting) than those who were not. Childhood sexual abuse was linked to greater consumption of alcohol and a higher number of sexual partners, a study of adult men found. The ACE Study also found that those who were sexually abused were twice as likely to use illicit drugs.

Such results are not unique to the United States. A recent study of children and adolescents in Hunan, China, found that those who were sexually abused were more than twice as likely to smoke, binge drink, and attempt suicide. And an Australian study reported that those who were sexually abused as children were at significantly greater risk for major affective, personality, and stress-related mental-health disorders.

Increasing public awareness around the health consequences of childhood sexual abuse, however, is only one small piece in the prevention puzzle.

Employers should embrace policies and procedures aimed at preventing abuse. State laws  requiring suspected sexual abuse to be reported to police require suspected sexual abuse to be reported to police might help. Nationally, the United States should ratify the international Convention on the Rights of the Child. We are the only nation other than Somalia that has failed to do so. Ratifying the convention would hold the United States legally accountable to policies and practices that protect children. According to The Heritage Foundation, a conservative think tank, such action would "infringe" upon parental rights.

Preventing the sexual abuse of children requires a cultural shift across all of society, not just a single institution in a single state.

Read more about The Public's Health.

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About this blog

What is public health — and why does it matter?

Through prevention, education, and intervention, public health practitioners - epidemiologists, health policy experts, municipal workers, environmental health scientists - work to keep us healthy.

It’s not always easy. Michael Yudell, Jonathan Purtle, and other contributors tell you why.

Michael Yudell, PhD, MPH Associate Professor, Dornsife School of Public Health, Drexel University
Jonathan Purtle, DrPH, MSc Assistant Professor, Drexel University School of Public Health
Janet Golden, PhD Professor of history, Rutgers University-Camden
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