Social vulnerability implicated in urinary incontinence burden in women

Women who are socially vulnerable appear to have worse urinary incontinence (UI) and poorer incontinence-related quality of life, according to a study.

The study included 1,004 women with UI who complete questionnaires on UI symptoms and incontinence-specific quality of life. Community-level social vulnerability was measured using the social vulnerability index (SVI) from census-level data.

Women living in high SVI (n=136) vs low SVI (n=868) areas were younger (mean age 39.2 vs 49.5 years), less likely to be White (25.0 percent vs 74.2 percent, had lower BMI (mean 25.3 vs 28.5 kg/m²), were less likely to have postsecondary education (77.9 percent vs 80.9 percent), and commonly had a household income below the poverty guideline (26.5 percent vs 10.7 percent).

High SVI was associated with worse urinary symptoms on the Lower Urinary Tract Dysfunction Research Network 10-item Symptom Index (LURN SI-10), worse UI severity on the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF), and worse overall UI-specific quality of life.

Multivariable logistic regression living in high SVI area increased the odds of having a moderate UI or severe/very severe UI by three- to fourfold (adjusted odds ratio [aOR], 3.34, 95 percent confidence interval [CI], 1.56–7.17; p=0.002 and aOR, 4.23, 95 percent CI, 1.76–10.17; p=0.001, respectively).

The odds of having a higher ICIQ LUTSqol score were also greater among women living in high vs low SVI areas (aOR, 10.5, 95 percent CI, 1.03–1.07; p<0.0001).

The findings demonstrate how community-level drivers of health influence urologic outcomes and urinary conditions, and that the SVI measure may be a useful tool to identify communities who may benefit most from targeted policy intervention efforts.