Department of OB/GYN, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Department of GYN/OB, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Urol. 2021 May;205(5):1415-1420. doi: 10.1097/JU.0000000000001545. Epub 2020 Dec 22.
Social determinants of health may significantly impact overall health and drive health disparities. We evaluated the association between social determinants of health and overactive bladder severity.
We conducted a multicenter, cross-sectional study of patients presenting to outpatient female pelvic medicine and reconstructive surgery clinics at Montefiore Medical Center (Bronx, New York) and Johns Hopkins Bayview Medical Center (Baltimore, Maryland) from November 2018 to November 2019. Surveys were administered to screen for overactive bladder (Overactive Bladder-Validated 8-Question Screener) and to evaluate social determinants of health. Ordinal logistic regression models were used to examine the association between overactive bladder symptom level and social determinants of health items, while adjusting for age, race, body mass index, parity, history of pelvic surgery and clinical site.
A total of 256 patients with a mean±SD age of 58.6±14.2 years and body mass index of 30.4±7.5 kg/m were recruited over a 12-month period. Our sample was 33.6% White, 32% Black and 29.3% Hispanic, with 5.1% categorized as other. A higher overactive bladder symptom level was associated with food insecurity (OR 2.51, 95% CI 1.03-6.11), financial strain (OR 1.94, 95% CI 1.06-3.53), difficulty finding or keeping employment (OR 3.14, 95% CI 1.01-9.72) and difficulty concentrating (OR 2.48, 95% CI 1.25-4.95), after adjusting for site, age, race, body mass index, parity and previous pelvic surgery.
In this cross-sectional study, certain social determinants of health were associated with greater overactive bladder severity. Unmet social needs may impact the success of overactive bladder treatment. Urologists should consider collaborating with social work and mental health specialists to better serve patients with overactive bladder and social determinants of health needs.
健康的社会决定因素可能会显著影响整体健康状况，并导致健康差距。我们评估了健康的社会决定因素与膀胱过度活动症严重程度之间的关系。
我们进行了一项多中心、横断面研究，纳入了 2018 年 11 月至 2019 年 11 月期间在蒙特菲奥雷医疗中心（纽约州布朗克斯）和约翰霍普金斯湾景医疗中心（马里兰州巴尔的摩）的女性盆腔医学和重建外科门诊就诊的患者。通过问卷调查筛查膀胱过度活动症（膀胱过度活动症-验证的 8 个问题筛查器），并评估健康的社会决定因素。使用有序逻辑回归模型来检验膀胱过度活动症症状水平与社会决定因素之间的关系，同时调整年龄、种族、体重指数、产次、盆腔手术史和临床地点。
在 12 个月的时间内，共招募了 256 名平均年龄为 58.6±14.2 岁、体重指数为 30.4±7.5kg/m 的患者。我们的样本中，33.6%为白人，32%为黑人，29.3%为西班牙裔，5.1%为其他种族。较高的膀胱过度活动症症状水平与食物不安全（OR 2.51，95%CI 1.03-6.11）、经济压力（OR 1.94，95%CI 1.06-3.53）、就业困难（OR 3.14，95%CI 1.01-9.72）和注意力集中困难（OR 2.48，95%CI 1.25-4.95）相关，在调整了地点、年龄、种族、体重指数、产次和既往盆腔手术后。
在这项横断面研究中，某些健康的社会决定因素与更严重的膀胱过度活动症有关。未满足的社会需求可能会影响膀胱过度活动症治疗的效果。泌尿科医生应考虑与社会工作者和心理健康专家合作，为有膀胱过度活动症和社会决定因素需求的患者提供更好的服务。
