Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Department of Urology, Vanderbilt University Medical Center, Nashville, TN.
Urology. 2024 Sep;191:72-78. doi: 10.1016/j.urology.2024.06.071. Epub 2024 Jul 4.
To investigate whether being "at-risk" for toilet and sanitation insecurity in the United States is associated with urinary symptoms, voiding behaviors, and psychosocial burden. Based on census data, nearly 2 million people in the United States do not have access to adequate plumbing. More may have inconsistent access related to cost, inadequate facilities for the number of people in a home, or declining regional infrastructure. The effects of inadequate access in the United States are poorly characterized.
This is a secondary analysis of a community-based sample of adults electronically recruited to complete questionnaires on clinical and sociodemographic information, living situations, home toilets and plumbing, urinary symptoms, compensatory bladder behaviors, and psychosocial burden. Multivariable logistic regression was used to assess for associations between being at-risk for toilet and sanitation insecurity and urinary and psychosocial symptoms. Linear regression was used to assess for association with adopting compensatory bladder behaviors.
This sample included 4218 participants, of whom 17% were identified as being at-risk for toilet and sanitation insecurity. Being at-risk for toilet and sanitation insecurity was associated with worse overall urinary symptoms and greater bother from these symptoms, in addition to worse self-assessed mental and physical health, anxiety, stress, depression, and fewer social supports. Finally, those at-risk for toilet and sanitation insecurity were more likely to adopt burdensome and unhealthy compensatory bladder behaviors.
As with other social determinants of health, toilet and sanitation insecurity may be an under-appreciated contributor to urinary symptoms, unhealthy toileting behaviors, and psychosocial distress.
研究美国“存在如厕和卫生设施不安全风险”是否与尿症状、排尿行为和心理社会负担有关。根据人口普查数据，美国近 200 万人无法获得足够的管道设施。更多人可能由于成本、家庭人数不足的设施或地区基础设施的衰退而无法获得稳定的管道设施。美国的这些不足造成的影响尚未被充分描述。
这是一项对基于社区的成年人样本的二次分析，这些成年人通过电子方式招募来完成关于临床和社会人口统计学信息、生活状况、家庭厕所和管道设施、尿症状、代偿性膀胱行为以及心理社会负担的问卷。多变量逻辑回归用于评估存在如厕和卫生设施不安全风险与尿症状和心理社会症状之间的关联。线性回归用于评估与采用代偿性膀胱行为之间的关联。
本样本包括 4218 名参与者，其中 17%被确定为存在如厕和卫生设施不安全风险。存在如厕和卫生设施不安全风险与更严重的整体尿症状和这些症状更大的困扰有关，此外还与自我评估的心理健康和身体健康状况更差、焦虑、压力、抑郁以及社交支持更少有关。最后，存在如厕和卫生设施不安全风险的人更有可能采用负担沉重和不健康的代偿性膀胱行为。
与其他健康的社会决定因素一样，如厕和卫生设施不安全可能是尿症状、不健康的如厕行为和心理社会困扰的一个被低估的因素。
