To investigate the association between a composite measure of adverse social determinants of health (SDOH) and overactive bladder (OAB) among US adults, and to assess the potential role of depression in this relationship.
We conducted a cross-sectional analysis of adult participants (≥ 18 years) from the 2005-2016 National Health and Nutrition Examination Survey (NHANES). A composite SDOH score (range 0-8) was derived from eight adverse conditions across economic, educational, healthcare, housing, and social domains. OAB was defined using the Overactive Bladder Symptom Score (OABSS ≥ 3). Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9 ≥ 10). Survey-weighted multivariable logistic regression models were used to examine associations, adjusting for covariates. Mediation analysis quantified the proportion of the SDOH-OAB association explained by depression.
Among 27,429 participants (weighted n = 191.7 million), the prevalence of OAB was 19.3%. In the fully adjusted model, each 1-unit increase in the SDOH score was associated with 16% higher odds of OAB (OR 1.16; 95% CI 1.14-1.18). A clear dose-response relationship was observed across SDOH categories (P for trend < 0.01). Key individual SDOH components, including unemployment, poverty, and food insecurity, were independently associated with OAB. Depression accounted for a substantial proportion of the total association between SDOH and OAB. The positive SDOH-OAB association was consistent across most subgroups, and findings were robust in sensitivity analyses.
A greater burden of adverse social determinants of health is associated with an increased prevalence of OAB in US adults. This relationship may be partially explained by depression.
International urogynecology journal. 2026 Apr 24 [Epub ahead of print]
Renjie Huang, Miao Huang, Rui Zhang
Department of Andrology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, 150040, China., Department of Neurology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, 150040, China., Department of Andrology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, 150040, China. .