MP30-16 ASSOCIATION OF OVERACTIVE BLADDER (OAB) WITH SOCIAL DETERMINANTS OF HEALTH (SDOH)

Abstract

Introduction: Social Determinants of Health (SDOH) may significantly impact overall health and drive health disparities. Key SDOH areas include housing instability, food security, transportation problems, utility needs, interpersonal safety, financial strain, employment, family and community support, education, physical activity, substance use, mental health, and disabilities. Objective: Our aim was to evaluate the association between SDOH and overactive bladder (OAB). Methods: We conducted a multi-center, prospective observation cohort study of new 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) beginning in November 2018. Surveys were administered to screen for OAB (OAB-V8), and to evaluate SDOH. An ordinal logistic regression model was used to examine the association between OAB symptom level (score ≤8, 9-25, ≥ 25) and SDOH item, while adjusting for age and race. Results: 179 patients were recruited over a 10-month period with median age 67.5 years (IQR 51-69). 44.1% were White, 32.0% were Black, and 19.6% were Hispanic. A higher OAB symptom level was associated with increasing anxiety (p = 0.03), disability (p=0.035), employment (p = 0.008) and needing support (p = 0.02), after adjusting for age and race in ordinal logistic regression analysis. See Table. Conclusions: In a small prospective cohort, certain SDOH variables (anxiety, disability, employment, and needing support) were associated with OAB severity. It is important for providers to recognize the success of OAB treatment may be impacted by SDOH. OAB treatment in these patients may be more successful with a holistic approach that addresses mental health, accessibility, employment, and support. FPMRS physicians should consider collaborating with social work and mental health specialists to better serve patients with OAB and SDOH needs.