Department of Family Medicine and Community Health, University of Minnesota Medical School, Program in Health Disparities Research, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA.
Division of Biostatistics, University of Minnesota School of Public Health, University Office Plaza 2221 University Ave SE, Suite 200, Minneapolis, MN, 55414, USA.
Soc Sci Med. 2024 Jan;341:116547. doi: 10.1016/j.socscimed.2023.116547. Epub 2023 Dec 26.
This study examines whether discriminatory experiences are associated with lower urinary tract symptoms (LUTS) and their impact among 972 women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which recruited participants from 4 cities in the United States.
Exposure to discrimination was assessed 3 times (1992-93, 2000-01, 2010-11) and averaged across assessments. Participants separately reported whether they experienced discrimination on the basis of their gender, race or color, and socioeconomic position or social class. For each social identity, discrimination was assessed in 6-7 settings (e.g., when getting a job, medical care, or housing). At different time points, women who reported discriminatory experiences for a given social identity were asked how frequently the discrimination occurred and how stressful experience(s) were. Following the 2010-11 assessment, data on LUTS and their impact were collected. Women were classified into bladder health versus mild, moderate, or severe symptoms/impact clusters.
More Black than White women reported discriminatory experiences across all social identities and most settings. Perceived stress of discriminatory experiences did not differ between Black and White women. In analyses stratified by race and social identity, White women reported LUTS/impact with discriminatory experiences in more settings, more frequent discriminatory experiences across settings, and each additional social identity for which discrimination was experienced. Black women reported LUTS/impact with more frequent discriminatory experiences across settings. For Black women, greater perceived stress of both gender and race discrimination were associated with LUTS/impact. For White women, only greater perceived stress of race discrimination was associated with LUTS/impact.
This is one of the first studies to examine discrimination in relation to LUTS/impact. Additional research is needed to better understand differences in how discriminatory experiences based on potentially intersecting identities may be related to bladder health among women.
本研究旨在探讨在冠状动脉风险发展中的年轻人（CARDIA）队列研究中，972 名女性的歧视经历是否与下尿路症状（LUTS）及其影响相关，该研究招募了来自美国 4 个城市的参与者。
歧视暴露情况评估了 3 次（1992-93 年、2000-01 年、2010-11 年），并取平均值。参与者分别报告他们是否基于性别、种族或肤色以及社会经济地位或社会阶层经历过歧视。对于每种社会身份，歧视在 6-7 个环境中进行评估（例如，找工作、医疗保健或住房）。在不同的时间点，对于给定的社会身份报告有歧视经历的女性，被问及歧视发生的频率和压力体验的程度。在 2010-11 年评估后，收集了关于 LUTS 及其影响的数据。女性被分为膀胱健康与轻度、中度或重度症状/影响组。
与白人女性相比，更多的黑人女性报告了所有社会身份和大多数环境中的歧视经历。黑人女性和白人女性在歧视经历的感知压力方面没有差异。在按种族和社会身份分层的分析中，白人女性报告了更多环境中与歧视经历相关的 LUTS/影响，在跨环境中更频繁的歧视经历，以及经历了更多的其他社会身份。黑人女性报告了在跨环境中更频繁的歧视经历与 LUTS/影响。对于黑人女性，性别和种族歧视的感知压力越大，与 LUTS/影响相关的可能性越大。对于白人女性，只有种族歧视的感知压力越大，与 LUTS/影响相关的可能性越大。
这是最早研究歧视与 LUTS/影响之间关系的研究之一之一。需要进一步研究，以更好地了解基于潜在相交身份的歧视经历如何与女性的膀胱健康相关。
