Overall and sex-specific associations between secondary trauma exposure and health decline post October 7th, 2023: a population-based study.

Profession-related secondary trauma exposure was inversely associated with worsening health behaviors overall, with this trend appearing only in men in sex-stratified analyses.

• In sex-stratified analyses, profession-related exposure showed 8.3–19.5% lower predicted probabilities of worsening outcomes in men.
• The inverse association in men extended across multiple outcomes, not just health behaviors.
• This finding was described as 'unexpected' by the authors.
• Overall logistic regression models were adjusted for sociodemographic factors, social wellbeing, and direct/indirect trauma.

Exposure to firsthand accounts of trauma was associated with worsening health behaviors in men and worsening mental health in women.

• Firsthand account exposure was associated with a 12.0% increase in predicted probability of worsening health behaviors in men.
• Firsthand account exposure was associated with a 14.6% increase in predicted probability of worsening mental health in women.
• These sex-specific patterns were identified through sex-stratified logistic regression models estimating average marginal effects.
• The outcome for men was initiation of ≥2 negative health behaviors.

Media exposure via television and internet/social media was associated with worsening sleep.

• Both television and internet/social media were identified as sources associated with worsening sleep outcomes.
• Exposure to multiple media sources was associated with both worsening sleep and worsening mental health.
• A cumulative media-exposure effect was observed only in women.
• Newspaper and radio were also assessed as media sources in the survey.

A cumulative media exposure effect on health outcomes was observed exclusively in women.

• Exposure to multiple media sources was associated with both worsening sleep and worsening mental health.
• The cumulative effect of media exposure across sources was sex-specific, appearing only in women.
• Four media source types were assessed: television, internet/social media, newspaper, and radio.
• Sex-stratified logistic regression models were used to identify this sex-specific pattern.

Secondary trauma exposure was associated with health decline beyond the effects of direct and indirect war-related trauma.

• All models were adjusted for both direct and indirect trauma exposure in addition to sociodemographic factors and social wellbeing.
• Outcomes assessed included self-reported worsening mental health, worsening physical health, worsening sleep, and initiation of ≥2 negative health behaviors.
• The study was conducted among n = 1128 Israeli adults (50% women) approximately six months after the October 7th, 2023 terror attack.
• Secondary trauma exposure was assessed by source: professional activity, firsthand accounts, and media (television, internet/social media, newspaper, radio).

The study used a population-based survey design among Israeli adults to examine associations between secondary trauma exposure and multiple health outcomes six months after the October 7th attack.

• Sample size was n = 1128 Israeli adults with 50% women.
• The survey was administered approximately six months after the October 7th, 2023 terror attack in Israel.
• Average marginal effects were estimated using overall and sex-stratified logistic regression models.
• Models were adjusted for sociodemographic factors, social wellbeing, and direct/indirect trauma exposure.