The cumulative effect of unmet social needs on noncancerous genitourinary conditions and severity of lower urinary tract symptoms.
The cumulative effect of unmet social needs on noncancerous genitourinary conditions and severity of lower urinary tract symptoms.
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DOI：
10.1002/nau.25038
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发表时间：
2022-11
影响因子：
2
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中科院分区：
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人们日益认识到健康的社会决定因素如何可能对健康结果产生重大影响。本研究的目的是探讨未满足的社会需求与多种非癌性泌尿生殖系统疾病的发生率和严重程度之间的关系。以电子方式招募以社区为基础的美国成年人样本，填写有关临床和人口统计信息、泌尿系统症状和社会需求的问卷。采用Logistic回归来评估未满足的社会需求数量与各种非癌性泌尿生殖系统疾病和下尿路症状严重程度之间的影响。模型根据年龄、性别、种族、保险和居住社区类型进行了调整。4224名参与者被纳入最终分析。所有泌尿生殖系统疾病的发生率与未满足的社会需求的增加有关。此外，与没有需求相比，有3个或更多未满足的社会需求与所有疾病和更严重症状的风险增加相关——包括间质性膀胱炎风险增加23.7% (95% CI 18.8-28.7%, p<0.001)，急迫性尿失禁风险增加21.9% (95% CI 16.8-27.0%, p<0.001)，膀胱过度活动风险增加20.6% （95% CI 15.6-25.7, p<0.001）。未满足的社会需求与非癌性泌尿生殖系统疾病发生率的增加以及症状严重程度的恶化有关，多种未满足的社会需求显示出累积效应。这些发现表明，筛查患者未满足的社会需求是有用的，卫生保健系统应该为有泌尿系统疾病的患者制定更综合的方法。
There is growing awareness on how social determinants of health may significantly influence health outcomes. The purpose of this study was to investigate the relationship between unmet social needs and the incidence and severity of multiple noncancerous genitourinary conditions. A community-based sample of United States adults was recruited electronically to complete questionnaires on clinical and demographic information, urinary symptoms, and social needs. Logistic regression was used to assess the effect between the number of unmet social needs and various noncancerous genitourinary conditions and severity of lower urinary tract symptoms. Model was adjusted for age, gender, race, insurance, and type of living community. 4,224 participants were included for final analysis. Incidence of all genitourinary conditions assessed was associated with an increasing number of unmet social needs. Additionally, having 3 or more unmet social needs, as compared to no needs, was associated with an increased risk of all conditions and worse symptoms – including a 23.7% increased risk of interstitial cystitis (95% CI 18.8–28.7%, p<0.001), 21.9% risk of urge urinary incontinence (95% CI 16.8–27.0%, p<0.001), and 20.6% risk of overactive bladder (95% CI 15.6–25.7, p<0.001). Unmet social needs are associated with an increased incidence of noncancerous genitourinary conditions as well as worse symptom severity, with multiple unmet social needs displaying a cumulative effect. These findings suggest that there is utility in screening patients for unmet social needs and that the health care system should develop a more integrated approach for patients with urinary conditions.