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Dr. Abraham and Dr. Kim on food insecurity’s effects on urge urinary incontinence


“There are a lot of social determinants of health as it relates to urge urinary incontinence,” says Joseph Kim, MD.

In this video, Nitya E. Abraham, MD, and Joseph Kim, MD, discuss the future research needs and the take-home message from the recent Journal of Urology study, “Food Insecurity is Associated with Urge Urinary Incontinence: An Analysis of the 2005-2010 National Health and Nutrition Examination Survey (NHANES).” Abraham is an associate professor of urology, female pelvic medicine, and reconstructive surgery and Kim is an incoming PGY-1 resident at Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.


Is further research on this topic planned? If so, what will it focus on?

Abraham: I think what the findings of our study show is that there is a broader problem that's affecting the urologic health of our patients. We're not able to get it down to just dietary factors. Granted, a limitation of the study was that diet was assessed with just a 24-hour survey, so we may be missing a bigger picture of their diet, given the limitations of the NHANES survey. That being said, I think that food insecurity probably is just pointing toward a larger problem of social inequity affecting many aspects of a person's life that is ultimately affecting their urologic health or specifically overactive bladder. And so the future I think, is it inspires us to think more broadly than just at the disease at the level of the bladder, but how overall social determinants of health are affecting our patients' health and how we can make an impact. One way our department has addressed is that we have a social worker in our group that we can refer patients to if we find out that they have issues with housing, food insecurity, legal issues. We're able to connect them with a social worker who can then connect them with services, and so ultimately that may be better for their overall health than any one medication that we provide in a visit.

Kim: The take-home message would be that there are a lot of social determinants of health as it relates to urge urinary incontinence. It's very important for urologists to be mindful of how different aspects of patients' lives can have an effect on their clinical picture. We know that urge urinary incontinence is very highly prevalent in the United States. [It has been reported that] up to 30% of women suffer from urinary incontinence, and this may actually be underreported because patients often find it difficult to talk about it. I think it'll be good for us to be cognizant and ask about these symptoms for patients that don't necessarily complain about it on their initial visits.

Abraham: I think we're just uncovering how much social determinants of health can affect our patients urologic health, and so something for us to consider going forward is screening for unmet social needs as a routine part of a new patient evaluation.

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