Background: Despite increasing understanding of the lasting psychological effects of sexual, physical, and emotional trauma in women, very little has been learned about long-term medical sequelae of such victimization. We wondered if women with prior victimization experiences might be at risk for increased rates of physical disease, engage in more health risk behaviors, and be more likely to have medically unexplained physical symptoms. This is the first report of a 5-year National Institute of Mental Health grant to study the impact of prior childhood neglect and sexual, physical, and emotional victimization on health status and health care use. Methods: An extensive pilot questionnaire was mailed to a random sample of 1,000 women age 18-45 who are members of Group Health Cooperative, a health maintenance organization in Seattle, Washington. The questionnaire inquired about general physical health, prior pain complaints and disability, gynecologic and sexual health, safer sex practices, mental health use, and dental fears. Items were used from previously validated instruments whenever possible. The questionnaire also incorporated a modification of the Briere Child Maltreatment Interview, a comprehensive inquiry into past episodes of sexual, emotional, and physical victimization, and neglect. We calculated the prevalence rates of each form of victimization as well as the effects of single and combination forms of trauma on health variables. Results: Questionnaires were returned by 462 women (46.2%). Compared with nonvictims, women with prior victimization histories had poorer general health as well as significantly higher rates of chronic pain, disability, teen pregnancies, abortions, miscarriages, sexually transmitted diseases, and sexual adjustment problems. They also reported a significantly greater number of high-risk health behaviors including smoking, low seat-belt use, alcohol abuse, and increased number of sexual partners. Mental health visits, prescription medication use, and refusal of dental care were also significantly higher. Prevalence rates for the victimization items are seen in the following table:Conclusions: Sexual, physical, and emotional victimization and neglect appear to be important factors in health care status and use in women. Despite the high prevalence rates for these conditions, most women do not disclose their victimization status to their providers.