Reduce health care costs by preventing childhood sexual abuse

Local, state, and federal governments, individuals and businesses — everyone is looking to reduce health care costs. Here’s one answer:

Increase the efforts to prevent the childhood sexual abuse epidemic.

Childhood sexual abuse is, indeed, an epidemic.

The Los Angeles Times conducted a national survey asking adults about their own childhood sexual abuse and 16% of the men who were polled reported that they were survivors of childhood sexual abuse.

In one study of 5,526 female Navy recruits with an average age of 19 years old, 19% of them reported they had been sexually abused as a child.

There usually is not any physical evidence in childhood sexual abuse cases. It is a hidden injury that victims often do not speak about, and the most commonly noticed symptoms are emotional ones.

The most commonly diagnosed disorders in sexually abused children are attention-deficit hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD).

One study of the linkage between ADHD and childhood sexual abuse found that all the girls who were diagnosed with both ADHD and sexual abuse were twice as likely to also have oppositional defiant disorder than the ADHD girls without an abuse history.

A long-term New Zealand study that tracked 1,000 children from birth found that those who experienced childhood sexual abuse later had higher rates of anxiety disorder, conduct disorder, major depression and suicidal behaviors than those who had not.

American studies have also found that teens who experienced sexual abuse are likely to be more depressed than their non-abused peers.

Childhood sexual abuse victims as youths have significantly higher rates of multiple sexual partners, unprotected intercourse, sexually transmitted disease, teenage pregnancy and repeated sexual assaults after the age of 16.

A survey given to eighth- and 10th-grade female students in the southern United States determined that the girls with a history of childhood sexual abuse were more likely to have been pregnant, to have initiated sexual intercourse at a younger age, to use illegal drugs, to be depressed, and to have more frequent suicidal ideation.

In fact, a review of 45 studies revealed that sexually abused children have 15 to 45% more psychiatric symptoms than non-abused children. Contrary to our preconceptions, sexually abused boys have considerably more emotional and behavioral problems, including suicidality, than sexually abused girls.

The effects of childhood sexual abuse are long-term.

One study re-evaluated children and their non-offending parents five years after the first report of their sexual abuse. There were no significant changes in the children’s depression, self-esteem or behavior. Forty-three percent of the children were sad or depressed, 43% had low self-esteem and 46% had behavioral dysfunction. The amount of children who had gotten better was matched by the same amount who had deteriorated.

Surprisingly, the children’s treatment had not yet shown a measurable beneficial effect for them. However, as we might expect, further contact with the abuser did deepen the children’s depression and continue to lower their self-esteem.

It seems the only sure way to reduce the pain caused by childhood sexual abuse is to increase our prevention efforts. Maybe the fact that it will also cause a huge reduction in children’s health care costs will now be sufficient motivation for us to do so.

Sharman practices law in Culpeper. His column appears each Tuesday.