Diverging paths: Health-care inequities by age among sexually abused children with disabilities.
Journal
Child abuse & neglect
Journal Volume
169
Journal Issue
Pt 2
Start Page
Article number 107723
ISSN
1873-7757
Date Issued
2025-11
Author(s)
Abstract
Objective: This study investigated disparities in health and health-care outcomes between children with disabilities who have experienced sexual abuse and children without disabilities having such experiences, considering different stages of childhood and adolescence. Methods: We utilized linked national datasets from Taiwan, leveraging comprehensive population-level data to analyze age-specific differences in health-care utilization. Eleven postassault health-care outcomes were analyzed, including mental health visits, pediatric and ophthalmology outpatient visits, obstetrics and gynecology care, pregnancy-related visits (3 indicators), self-harm, emergency room visits, general outpatient utilization, and total medical expenditure. Results: Among 19,133 sexually abused children, 7.4 % had a documented disability. Children with disabilities were more likely than those without disabilities to be from low-income families. Mental health outpatient visits were significantly higher among children with disabilities, particularly at younger ages (eg, 4.53 additional visits at age 1 [P < .001]), with the effect weakening with age. By contrast, younger children with disabilities had significantly fewer general and ophthalmology outpatient visits. Disability was associated with decreased use of pregnancy-related services at older ages and had no significant effect on self-harm or emergency room visits. Total medical expenditure was higher for children with disabilities, and disparities increased with age. Conclusion: In children with disabilities who have experienced sexual abuse, health-care utilization varies across age groups. These findings highlight a need for age-sensitive and disability-informed responses to trauma.
Subjects
Disabilities
Health-care disparities
Pediatric health services
Sexual abuse
Trauma-informed care
Type
journal article