To investigate whether social vulnerability is associated with the direct and indirect burdens of urinary incontinence (UI). UI affects over half of all adult women living in the United States and can affect quality of life. While individual-level social determinants of health have been associated with urologic disease, the effect of community-level factors is poorly characterized. Community-level social vulnerability as measured using the social vulnerability index (SVI) from census-level data has been associated with worse health outcomes.

Women with UI were recruited from our urology outpatient clinic and via ResearchMatch to complete questionnaires on UI symptoms and incontinence-specific quality of life. Home zip code was merged with census data to determine SVI. Urinary symptom severity and quality of life were compared between those living in low vs high social vulnerability areas, and multivariable logistic regression was performed.

This sample included 1004 women. Women with UI living areas with the highest social vulnerability had significantly worse UI severity and incontinence-specific quality of life, even after adjusting for covariates.

In this cohort, community-level social vulnerability is associated with worse UI and worse incontinence-specific quality of life in women, even when controlling for multiple covariates. This suggests that community-level drivers of health play a significant role in 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.