Common health problems in safety-net primary care: Modeling the roles of trauma history and mental health

Abstract

Objective: This study described trauma exposure and investigated mediational effects of mental health on the relationships between trauma and pain, sleep, smoking, and general health. Method: Participants were 210 low-income primary care patients. The study used a crosssectional, self-report survey design. Results: Eighty-five percent of the sample reported adult trauma and 54% reported four or more childhood traumas. Moderate or higher depression and anxiety levels were present in 59% and 48% of participants, respectively. Structural equation model fit was good for sleep, pain, and general health, showing that trauma indirectly affected health variables via mental health. Conclusions: Participants endorsed substantial adult and childhood trauma, which likely had cascading effects on mental health and common primary care presenting health issues.