Background
Physical and sexual childhood abuse is associated with poor health across the lifespan. However, the association between these types of abuse and actual health care use and costs over the long run has not been documented.
Objective
To examine long-term health care utilization and costs associated with physical, sexual, or both physical and sexual childhood abuse.
Introduction Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults.
Methods We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate.
The University of Florida’s Dr. Nancy Hardt has an unusual double specialty: She’s both a pathologist and an OB-GYN. For the first half of her career, she brought babies into the world. Then she switched — to doing autopsies on people after they die.
“I want to prevent what I’m seeing on the autopsy table. … A lot of times, I’m standing there going, ‘I don’t think this person had a very nice early childhood.’ ”
Dr. Nancy Hardt, pathologist, University of Florida
It makes perfect sense to her.
“Birth, and death. It’s the life course,” Hardt explains.
A few years ago, Hardt says, she learned about some research that changed her view of how exactly that life course — health or illness — unfolds.
Dear Doctor: What you didn’t ask, and what I didn’t tell you
I am your patient. We have known one another for a long time, and I want to thank you for healing me so many times.
At present, you know me only from annual checkups as a healthy 58-year-old, divorced, Caucasian female; 120 lbs, 5’6″; two adult children; parents and all four siblings living; family history of diabetes, epilepsy, alcoholism, bowel cancer, and heart disease; no medications.
You met me first in 1943 in Pennsylvania. I was a normal 5 lb 6 oz infant, born under general anesthesia. My mother nursed me for eight months, and I grew normally. You were surprised and concerned when I returned in six weeks for a well-baby check and immunizations. I had developed an extremely loud heart murmur, but you assured my worried mother no surgery was needed.