TY - JOUR
T1 - Discrimination and bladder health among women in the CARDIA cohort study
T2 - Life course and intersectionality perspectives
AU - Brady, Sonya S.
AU - Arguedas, Andrés
AU - Huling, Jared D.
AU - Hellemann, Gerhard
AU - Lewis, Cora E.
AU - Fok, Cynthia S.
AU - Van Den Eeden, Stephen K.
AU - Markland, Alayne D.
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2024/1
Y1 - 2024/1
N2 - Objective: This study examines whether discriminatory experiences are associated with lower urinary tract symptoms (LUTS) and their impact among 972 women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which recruited participants from 4 cities in the United States. Method: Exposure to discrimination was assessed 3 times (1992–93, 2000–01, 2010–11) and averaged across assessments. Participants separately reported whether they experienced discrimination on the basis of their gender, race or color, and socioeconomic position or social class. For each social identity, discrimination was assessed in 6–7 settings (e.g., when getting a job, medical care, or housing). At different time points, women who reported discriminatory experiences for a given social identity were asked how frequently the discrimination occurred and how stressful experience(s) were. Following the 2010-11 assessment, data on LUTS and their impact were collected. Women were classified into bladder health versus mild, moderate, or severe symptoms/impact clusters. Results: More Black than White women reported discriminatory experiences across all social identities and most settings. Perceived stress of discriminatory experiences did not differ between Black and White women. In analyses stratified by race and social identity, White women reported LUTS/impact with discriminatory experiences in more settings, more frequent discriminatory experiences across settings, and each additional social identity for which discrimination was experienced. Black women reported LUTS/impact with more frequent discriminatory experiences across settings. For Black women, greater perceived stress of both gender and race discrimination were associated with LUTS/impact. For White women, only greater perceived stress of race discrimination was associated with LUTS/impact. Conclusions: This is one of the first studies to examine discrimination in relation to LUTS/impact. Additional research is needed to better understand differences in how discriminatory experiences based on potentially intersecting identities may be related to bladder health among women.
AB - Objective: This study examines whether discriminatory experiences are associated with lower urinary tract symptoms (LUTS) and their impact among 972 women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which recruited participants from 4 cities in the United States. Method: Exposure to discrimination was assessed 3 times (1992–93, 2000–01, 2010–11) and averaged across assessments. Participants separately reported whether they experienced discrimination on the basis of their gender, race or color, and socioeconomic position or social class. For each social identity, discrimination was assessed in 6–7 settings (e.g., when getting a job, medical care, or housing). At different time points, women who reported discriminatory experiences for a given social identity were asked how frequently the discrimination occurred and how stressful experience(s) were. Following the 2010-11 assessment, data on LUTS and their impact were collected. Women were classified into bladder health versus mild, moderate, or severe symptoms/impact clusters. Results: More Black than White women reported discriminatory experiences across all social identities and most settings. Perceived stress of discriminatory experiences did not differ between Black and White women. In analyses stratified by race and social identity, White women reported LUTS/impact with discriminatory experiences in more settings, more frequent discriminatory experiences across settings, and each additional social identity for which discrimination was experienced. Black women reported LUTS/impact with more frequent discriminatory experiences across settings. For Black women, greater perceived stress of both gender and race discrimination were associated with LUTS/impact. For White women, only greater perceived stress of race discrimination was associated with LUTS/impact. Conclusions: This is one of the first studies to examine discrimination in relation to LUTS/impact. Additional research is needed to better understand differences in how discriminatory experiences based on potentially intersecting identities may be related to bladder health among women.
KW - Bladder health
KW - Discrimination
KW - Gender
KW - Lower urinary tract symptoms
KW - Race
KW - Socioeconomic position
KW - United States
KW - Women
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U2 - 10.1016/j.socscimed.2023.116547
DO - 10.1016/j.socscimed.2023.116547
M3 - Article
C2 - 38159485
AN - SCOPUS:85181071507
SN - 0277-9536
VL - 341
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 116547
ER -