De-Stigmatization of Sexual Assault May Contribute to Related Increase in Emergency Department Visits

Data show that an increase in sexual assault-related emergency department visits in 2019 may be due to social de-stigmatization of sexual assault during the #metoo movement of that year.

Estimates show sexual assault occurs every 68 seconds in the United States. In the past 10 years, there have been 15 times more sexual assault-related emergency department (ED) visits, according to the authors of a study published in JAMA Network Open. This number is believed to outpace reports of sexual assault by law enforcement.

The number of adults (aged 18 to 65 years), who visited the ED for sexual assault increased by 51,689 between the years of 2006 and 2019.

"Sexual assault is a disturbing and prevalent trend in the U.S.,” said senior study author Erica Marsh, MD, chief of the division of reproductive endocrinology and infertility at the Center for Reproductive Medicine at the University of Michigan. “We know that people who experience sexual assault face numerous emergent health problems, but few seek emergency medical care."

The FBI reports that sexual assault (and rape) rose from 93,000 to 139,815 between 2006 and 2019. Victims are more prone to depression, suicidal thoughts, posttraumatic stress disorder, substance use, and chronic conditions than individuals who have not been assaulted.

The data shows that older people aged 46 to 65 years were more likely to be admitted to the hospital than younger people aged 18 to 25 years. Disproportionately, younger women with lower incomes sought ED help after assault.

Data suggests that 1 in 5 sexual assault survivors seek medical care, but care is often inadequate or incomplete. Additionally, few studies have looked at how individuals seek care after a sexual assault—that is what this study aimed to address.

Based on the study results, the investigators found that the number of individuals who sought ED care increased to 55,296 people in 2019—where social de-stigmatization of sexual assault during the #metoo movement of that year could be a contributing factor. The investigators noted that other factors may include how it is coded by emergency providers and a general increase in sexual assaults in the country, Marsh explained.

From 2006 to 2019, less than 1% of ED cases were classified as sexual assault.

"Although sexual assault comprises a small proportion of total emergency room visits, the magnitude of increase suggest that certain factors may be encouraging people who experience sexual assault to seek emergency care," Marsh said in the press release.

Furthermore, low-income, or government-insured, patients were found to be disproportionally admitted to the hospital. However, the disparity between visits and hospital charges related to sexual assault is stark—as of 2019, sexual assault-related costs were $233 million.

But hospital admission rates decreased in this time. Between the 13-year study period, sexual assault hospital admissions decreased by 8%, which may be due to lower-acuity cases. Also, patients chose to avoid the hospital for confidentiality purposes—or because there was less availability at the hospital.

The CDC suggest that more than 50% of women are affected by sexual assault, and more than 33% of men could be affected in their lifetimes.

"Tracking these trends will help inform policies and potential strategies for better supporting these individuals and for reaching others who may be less likely to seek emergency medical care for various reasons,” study authors wrote.

Reference

University of Michigan. Sexual assault-related ER visits increase more than tenfold. Science Daily. October 20, 2022. Accessed on October 25, 2022. https://www.sciencedaily.com/releases/2022/10/221020112820.htm

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