title: The influence of childhood physical abuse on adult health status in sexual minority women: the mediating role of smoking.
abstract: BACKGROUND
  Among women in the general population, childhood physical abuse (CPA) is associated with poor adult health status and engagement in health risk behaviors. Sexual minority women (SMW) are at elevated risk of CPA, have higher rates of smoking, and may be at higher risk for poorer general health. In this study, we examined the influences of CPA on health status in a diverse sample of SMW. We hypothesized that SMW with a history of CPA would report poorer health than those without such histories and that early onset of smoking-an important health risk behavior-would mediate the relationship between CPA and current health status.
  
  
  METHODS
  Structural equation modeling was used to evaluate the influence of CPA on early health risk behavior (i.e., age of smoking onset) and current perceived health status in a community based sample of 368 SMW.
  
  
  RESULTS
  More than one fifth of the sample (21.5%) reported a history of CPA. One fourth of the sample was current smokers; the average age of smoking onset was 19 to 20 years old. The mean level of self-rated health status was between "fair" and "good." When relationships were simultaneously estimated, the effect of CPA on health status was mediated by two sequential smoking factors: CPA was associated with earlier age of smoking onset, and age of smoking onset was associated with current smoker status. Being a current smoker had a negative effect on perceived health status.
  These results suggest that tobacco use is an important pathway by which CPA influences current health status. Prevention and early intervention initiatives should focus on the reduction of CPA among SMW to eliminate the long-term health consequences of adverse childhood events among SMW.
authors: Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois 60612, USA. aliciak@uic.edu
authors: Alicia K
authors: AK
authors: Matthews
authors: Young Ik
authors: YI
authors: Cho
authors: Tonda L
authors: TL
authors: Hughes
authors: Timothy P
authors: TP
authors: Johnson
authors: Lisa
authors: L
authors: Alvy
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000367:Age Factors; D002641:Chicago / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000208:ethnology / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult