Presentation (CTI)

OBJECTIVES: Child maltreatment is associated with a substantial economic burden over short and long terms, but little is known about its long-term impact on health-related quality of life (HRQoL). This study aimed to assess the longitudinal effect of child maltreatment on HRQoL, measured as utility scores, in a large nationally representative cohort of Australian women.
METHODS: A longitudinal dataset from a cohort of 7,048 women (born 1973-1978) participating in the Australian Longitudinal Study on Women’s Health (ALSWH) across nine survey waves spanning 25 years (1996-2021) was analyzed. Child maltreatment, including physical, emotional, and sexual abuse, was assessed using the Adverse Childhood Experiences (ACEs) scale in waves 7 and 8. HRQoL was measured across all waves using the SF-36 and converted to utility scores via the SF-6D using an Australian scoring algorithm. Linear mixed-effects models were employed to estimate the impact of maltreatment on HRQoL, adjusting for a wide range of demographics and lifestyle covariates.
RESULTS: Nearly 30% of participants experienced child maltreatment. These women exhibited significantly lower utility scores compared to those without maltreatment (mean difference = -0.05, Cohen’s d = 0.4). Emotional and sexual abuse were consistently associated with reduced utility scores. A dose-response relationship was observed, with increasing numbers of maltreatment types associated with greater declines in utility scores. The impact of child maltreatment on utility scores remained stable over the 25-year follow-up.
CONCLUSIONS: Child maltreatment is associated with a long-lasting reduction in HRQoL, with emotional, sexual, and multiple abuses having the most pronounced effects. These findings underscore the need for targeted interventions to mitigate the long-term health consequences of maltreatment, particularly among women.