TABLE 4.
Logistic Regression Models for Health Risk Behaviors and Mental Health Problems as Mediators Between Childhood Abuse and Adult Health Problems and Health Care Utilization: Ontario Health Survey, Mental Health Supplement, 1990–1991
| Predictor and Outcome Variables | Simple Model,a OR (95% CI) | Mediated Model,b OR (95% CI) | % Changec |
| At least 1 mental health problem in lifetime as mediator between childhood physical abuse and | |||
| Multiple health problems | 1.43 (1.17, 1.74) | 1.29 (1.05, 1.57) | −33 |
| Poor self-rated health | 1.37 (0.99, 1.89) | 1.23 (0.88, 1.70) | −38 |
| Pain | 1.91 (1.43, 2.55) | 1.70 (1.27, 2.28) | −23 |
| Disability | 1.83 (1.45, 2.31) | 1.69 (1.33, 2.15) | −17 |
| High emergency department use | 1.94 (1.47, 2.58) | 1.83 (1.37, 2.44) | −12 |
| High health professional use | 1.60 (1.25, 2.05) | 1.48 (1.15, 1.90) | −20 |
| At least 1 mental health problem in lifetime as mediator between childhood sexual abuse and | |||
| Multiple health problems | 1.81 (1.38, 2.37) | 1.59 (1.20, 2.10) | −27 |
| Poor self-rated health | 1.75 (1.14, 2.69) | 1.48 (0.95, 2.30) | −36 |
| Disability | 1.70 (1.21, 2.38) | 1.50 (1.06, 2.12) | −29 |
| High emergency department use | 1.93 (1.27, 2.92) | 1.77 (1.17, 2.69) | −17 |
| High health professional use | 1.74 (1.25, 2.42) | 1.58 (1.13, 2.21) | −22 |
| Mental health problems and all health risk behaviors as mediators between childhood physical abuse and | |||
| Multiple health problems | 1.44 (1.18, 1.75) | 1.22 (0.99, 1.50) | −50 |
| Poor self-rated health | 1.37 (0.99, 1.90) | 1.16 (0.83, 1.63) | −57 |
| Pain | 1.92 (1.43, 2.56) | 1.69 (1.25, 2.28) | −25 |
| Disability | 1.81 (1.43, 2.29) | 1.61 (1.26, 2.05) | −25 |
| High emergency department use | 1.95 (1.47, 2.59) | 1.78 (1.33, 2.38) | −18 |
| High health professional use | 1.60 (1.25, 2.05) | 1.45 (1.13, 1.87) | −25 |
| Mental health problems and all health risk behaviors as mediators between childhood sexual abuse and | |||
| Multiple health problems | 1.82 (1.38, 2.39) | 1.48 (1.12, 1.97) | −41 |
| Poor self-rated health | 1.72 (1.11, 2.65) | 1.30 (0.83, 2.05) | −58 |
| Disability | 1.65 (1.17, 2.32) | 1.39 (0.97, 1.97) | −42 |
| High emergency department use | 1.93 (1.28, 2.92) | 1.69 (1.11, 2.59) | −26 |
| High health professional use | 1.73 (1.24, 2.42) | 1.52 (1.08, 2.14) | −29 |
Note. OR = odds ratio; CI = confidence interval. The ORs are for the relationship between childhood abuse and health risk behaviors or mental health problems.
The simple model includes childhood abuse as the predictor variable and health indicators as the outcome variable. Age, gender, low education, and marital status are covariates.
The mediated model includes health risk behaviors as the mediator variable, childhood abuse as the predictor variable and health indicators as the outcome variable. Age, gender, low education, and marital status are covariates.
To calculate how much the the OR for abuse was attenuated when the mediator variable was added, we used the following formula: (OR [simple model] – OR [mediated model] / OR [simple model] – 1) × 100%.