Nearly half of U.S. patients don't tell their physicians about potentially life-threatening risks such as domestic violence, sexual assault, depression or thoughts of suicide, a new study finds.

"For physicians to achieve your best health, they need to know what you are struggling with," said study senior author Angela Fagerlin.

Understanding how to make patients feel more comfortable with health care providers is crucial to dealing with such life-threatening risks, said Fagerlin, chair of population health sciences at University of Utah Health.

She and her colleagues analyzed the responses of more than 4,500 people who took part in two national online surveys. One included more than 2,000 people, average age 36, and the other included nearly 2,500 people with a median age of 61.

Participants were asked if they'd withheld certain medical information from a health care provider, and why.

The results showed that 40%-47.5% of the respondents did not tell their health care provider about one of the four health threats. More than 70% said the reason for withholding the information was embarrassment or fear of being judged or lectured.

The rate of keeping such information to themselves was higher among women and younger patients than the overall rate, according to the study. The results were published online Aug. 14 in the journal JAMA Network Open.

The authors noted that patients who don't disclose they've been sexually assaulted are at risk for post-traumatic stress disorder and sexually transmitted diseases, including HIV. But the social stigma around sexual assault may make survivors reluctant to discuss it with anyone.

"These are things providers can help you with, such as getting resources, therapy and medication," Fagerlin said in a University of Utah news release.

The findings add to evidence of discomfort and a lack of trust between patients and health care providers, according to study first author Andrea Gurmankin Levy. She's a professor in social sciences at Middlesex Community College in Middletown, Conn.

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