The Effect of Social Determinants of Health on Overactive Bladder Symptom Severity.

Social Determinants of Health (SDOH) may significantly impact overall health and drive health disparities. Our aim was to evaluate the association between SDOH and Overactive Bladder (OAB) severity.

We conducted a multi-center, cross-sectional study of patients presenting to outpatient female pelvic medicine and reconstructive surgery (FPMRS) clinics at Montefiore Medical Center (Bronx, NY) and Johns Hopkins Bayview Medical Center (Baltimore MD) from November 2018 to November 2019. Surveys were administered to screen for OAB (OAB-V8) and to evaluate SDOH. Ordinal logistic regression models were used to examine the association between OAB symptom level and SDOH items, while adjusting for age, race, BMI, parity, history of pelvic surgery, and clinical site.

Two hundred fifty six patients were recruited over a 12-month period with mean age 58.6 (SD 14.2) and mean BMI 30.4 (SD 7.5). Our sample was 33.6% White, 32% Black, 29.3% Hispanic, and 5.1% categorized as Other. A higher OAB 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, BMI, parity and previous pelvic surgery.

In this cross-sectional study, certain SDOH were associated with greater OAB severity. Unmet social needs may impact the success of OAB treatment. Urologists should consider collaborating with social work and mental health specialists to better serve patients with OAB and SDOH needs.

The Journal of urology. 2020 Dec 22 [Epub ahead of print]

Laura Tellechea, Stephanie Zuo, Jaden R Kohn, Melissa J Fazzari, Ruth Eisenberg, Justin Lee, Melissa Laudano, Chi Chiung Grace Chen, Nitya Abraham

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., Department of Epidemiology and Population Health, Montefiore Medical Center, Bronx, New York., Albert Einstein College of Medicine, Bronx, New York., Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

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