Sexual assault related ER visits increase more than tenfold

The rise in people seeking emergency medical care after sexual assault outpaces the growth of law enforcement reporting, study suggests.

11:00 AM

Author | Beata Mostafavi

er patient crying talking to medical care with teal and purple and grey colors behind curtain
Justine Ross, Michigan Medicine

An increasing number of people are seeking emergency medical help for sexual assault, a study suggests.

Emergency departments saw 15 times more sexual assault related visits in the past decade, outpacing the growth of law enforcement reporting, according to the research in JAMA Network Open.

"Sexual assault is a disturbing and prevalent trend in the U.S. We know that people who experience sexual assault face numerous emergent health problems but few seek emergency medical care," said senior author Erica Marsh, M.D., chief of the division of reproductive endocrinology and infertility at the Center for Reproductive Medicine at University of Michigan Health Von Voigtlander Women's Hospital.

"These findings demonstrate the role that healthcare providers can play in improving long-term medical and psychosocial health for these individuals."

A new sexual assault is estimated to occur every 68 seconds in the United States with nationally reported rapes and sexual assaults increasing from 93,000 in 2006 to 139,815 in 2019, according to data from the Federal Bureau of Investigation.

Studies suggest that people who have experienced sexual assault are at greater risk for suicidal ideation, posttraumatic stress disorder, depression, substance use and chronic conditions than peers who have not.

However, historically, a small percentage of people seek medical care for sexual assault – as few as one in five, according to some studies – and when they do, it's often incomplete or inadequate care.

"Some of the care provided by our partners in the emergency medicine space to these survivors could ideally come from a known, trusted provider who has an established relationship with the patient and where patients feel like they're in a safe space," Marsh said.

"We need to better understand where those opportunities are and how we can respond to these health needs in diverse outpatient settings."

Researchers analyzed national data from millions of emergency room visits a year, finding an increase from 3,607 adults ages 18-65 seeking emergency care after sexual assault in 2006 to 55,296 in 2019.

Although sexual assault comprises a small proportion of total emergency room visits, the magnitude of increase suggest that certain factors may be encouraging people who experience sexual assault to seek emergency care.
Erica Marsh, M.D.

Potential factors behind the increase could include societal de-stigmatization of sexual assault as well as changes in how emergency medicine providers code for it, and increasing prevalence of sexual assault in the U.S., Marsh says.

Meanwhile, there was a significant 8% decrease in admission rates for sexual assault during the same period – with more than 95% of these patients sent home after an ED visit and not being admitted to the hospital.

These decreasing hospital admission rates may be attributed to an increasing number of lower-acuity cases, more people preferring to avoid admission for confidentiality purposes, and/or decreased inpatient availability. 

ED visits overall also increased by 23% during the same time, with sexual assault visits making up less than 1% of visits. Still, total hospital charges for sexual assault-related visits topped $233 million in 2019, up from $6.35 million in 2006.

"Although sexual assault comprises a small proportion of total emergency room visits, the magnitude of increase suggest that certain factors may be encouraging people who experience sexual assault to seek emergency care," Marsh said.

Disparities in health needs, admissions

Patients with lower incomes and government insurance plans are disproportionately admitted to the hospital after sexual assault, the study suggests. Older people (aged 46-65) are also more likely to be admitted than younger people (ages 18-25).

This may be attributed to other underlying conditions that could increase need for hospitalization, Marsh says.

But those who seek help in the ED after sexual assault were also disproportionally younger women and those with lower incomes.

While sexual assault is highly prevalent— estimated to affect more than half of women and nearly a third of men in their lifetime, according to the Centers for Disease Control and Prevention—there have been few long-term studies of how people seek care after sexual assault.

Further studies should explore how to establish care for these patients in an outpatient or urgent care setting, Marsh says, such as providing testing for sexually transmitted infections, providing antibiotic and antiviral treatment on site, facilitating mental health services and collecting evidence in cases when patients are willing to be connected to law enforcement.

"Our findings highlight the populations who access emergency care most frequently and who is most likely to need hospitalized care," she said.

"Tracking these trends will help inform policies and potential strategies for better supporting these individuals and for reaching others who may be less likely to seek emergency medical care for various reasons."

Additional authors include Emily Vogt, B.A.; Charley Jiang, M.S.; Quinton Jenkins, M.P.H.; Maya Millette, B.S.; Martina Caldwell, M.D., M.S.; Kathleen Mehari, M.D.

Study cited: "Trends in US Emergency Department Use After Sexual Assault, 2006-2019," JAMA Network Open. DOI: 10.1001/jamanetworkopen.2022.36273


More Articles About: Rounds Gynecology Wellness and Prevention Emergency & Trauma Care Future Think Patient Safety Von Voigtlander Women's Hospital Health Care Delivery, Policy and Economics Womens Health Community Health Gender Hospitals & Centers
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Little girl sits on a bike that looks like a car and rides around the fake town, built to teach her about cross the street safely.
Department News
U-M’s Pop-Up Safety Town Teaches Injury Prevention and Helps Keep Kids Out of the ER
Pop-Up Safety Town, a community outreach initiative by the University of Michigan’s Department of Emergency Medicine in partnership with the U-M Concussion Center, brings free, hands-on injury prevention education to underserved communities across Michigan. Designed for children ages three to six, the program teaches vital safety skills, like helmet use, medication safety, and pedestrian awareness, through interactive events and classroom kits. By engaging families directly in schools and community spaces, and expanding through partnerships and national scaling efforts, the initiative aims to reduce preventable childhood injuries and keep kids out of the emergency room.
Group photos of the Scholars
Department News
Launching the Next Generation of Emergency Medicine Researchers
The K12 Neuro-EM Scholars Program, launched in 2024 at the University of Michigan’s Weil Institute and funded by the NIH’s National Institute of Neurological Disorders and Stroke, is the first national initiative designed to train early-career emergency medicine (EM) faculty in neurological research. With dedicated funding, mentorship, and a focus on high-impact research, the program supports scholars as they pursue independent research careers focused on critical, time-sensitive neurological emergencies. In its inaugural year, four scholars were selected, with additional support provided through a Pipeline Program for emerging researchers. The initiative is quickly building a nationwide community of EM physician-scientists committed to advancing care for neurological emergencies.
girl hugging teddy bear with alcohol bottles on ground
Health Lab
1 in 4 kids live with parents who have alcohol or other drug problems
Children living with parents who have addiction issues, also called substance used disorder, have higher risks later in life. A new study shows 1 in 4 currently live in such households.
person looking at test close up
Health Lab
Revolutionizing head injury care
A simple blood test is changing how emergency medicine operates.
Health Lab
'Unprecedented' level of control allows person without use of limbs to operate virtual quadcopter
Brain-computer interface enables paralysis patients to socialize with others and participate in remote work as well as recreational activities.
2025 blocks with stethoscope
Health Lab
Top 10 things to know about your health costs right now
From Medicare prescription costs and medical debt rules to actions that the Supreme Court, Congress and President Trump have taken or could take, a guide to health policies that affect many people.