Unexpected Cost Driver for Hospitals
Since 1989, The Monitor has explored issues related to physical and sexual abuse in the home and the workplace. From April 2003 to March 2004 in the most extensive exploration of its kind undertaken by a syndicated survey, The Monitor concentrated on issues related to abuse, health status and impacts on the healthcare sector. The results are clear. Not only is abuse unpleasant and often criminal, it has important cost consequences for the health sector - including the hospital sector.
Extent of Physical and Sexual AbuseThe April 2003 to March 2004 series asked about physical and sexual abuse "ever" and in the previous year, we found:
- 12% of the population 19 and older report they have been
- 1% of men and 9% of women report they have been sexually
- Of those physically abused, 15% report it happened in the past
- Of those sexually abused, 4% reported it happened in the past year
In all, the data suggest that approximately 2.8 million Canadians, 19 and older have been physically or sexually abused at some point in their lives; and approximately 420,000 of them were abused in this past year - this is without counting under-reporting. The regional data for physical and sexual abuse shows some wide variations.
We see here that residents of Nova Scotia are most likely to report physical or sexual abuse (19%) while those in Quebec are the least likely (8%).
Abuse and Health
People who are in "fair" or "poor health" are consistently more
likely to report they have been abused than are those in
"excellent" or "good health."
For example, we find that nationally, 12% of those in "excellent/ good health" report that they have been physically abused; by comparison, 16% of those in "fair/poor health" report they have been physically abused. The same patterns occur for both men and women for both physical and sexual abuse.
Lifestyle BehaviourPersons who report abuse are significantly more likely to report they undertake unhealthy lifestyle behaviours. Those who are abused are much more likely to smoke.
As we can see, those who smoke are twice as likely to report abuse as non-smokers. Conversely, 22% of those who are abused say they smoke compared to 17% of those not abused. (Abused men and women are also more likely to smoke in bed and to fall asleep in bed while smoking.)
We find similar patterns regarding diet:
We find the same patterns as with smoking.
- Abused men are more likely than non-abused men to drink five or
more drinks one or more days a week
- Abused women are more likely than non-abused women to have four
or more drinks one or more days a week;
- Abused men and women are more likely than those non-abused to have only one cup of fruit a day or no fruit at all.
Use of Health ServicesIt is not surprising, therefore, to find that those who are abused are significantly more likely to report they have used health services than those who were not abused.
As the chart shows, abused persons are:
- More likely to have used health services in the previous
- More likely to have found it difficult to access those health
- More likely to have been unable to obtain the health services
they needed when they needed them
- Less likely to eventually receive these needed health services
The higher proportion of users of health services among those reporting abuse represents about 300,000 people (more if one takes under-reporting into account). This is roughly comparable to the population of London, Ontario, or larger if one considers under-reporting.
AcknowledgmentTopics in The Berger Population Health Monitor are selected in consultation with subscribers, the Hay Health Care Consulting Group and the Canadian Fitness and Lifestyle Research Institute (CFLRI) in Ottawa. <>The Berger Population Health Monitor surveys are conducted jointly with the Physical Activity Monitor of the CFLRI. National surveys are conducted monthly and administered by the Institute for Social Research, York University. The abuse questions were administered in the monthly surveys from March 2003 to April 2004 to persons 19 and older, generating a sample of 7,126. For more information contact, Earl Berger, 416-815-6405 or e-mail: Earl_Berger@haygroup.com.
1. This does not include under-reporting. Based on our special studies we estimate that women under-report physical abuse by some 60% and men by about 21%. The population's responses to questions on abuse vary depending on how the questions are worded and the context in which they are placed.
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