Black women's perspectives on bladder health: Social-ecological and life course contexts.

This paper explores Black women's perspectives on bladder health using a social-ecological conceptual framework and life course perspective.

We conducted a directed content analysis of data from the Study of Habits, Attitudes, Realities, and Experiences (SHARE), a focus group study by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Analysis was conducted on data from five focus groups and a member-checking session where all participants self-identified as Black or African American.

Forty-two participants aged 11-14 or 45+ years reported life course experiences with their bladder. The intersection of race and gender was the lens through which participants viewed bladder health. Participants' accounts of their perspectives on bladder health explicitly and implicitly revealed structural racism as an explanatory overarching theme. Participants described (a) historically-rooted and still pervasive practices of discrimination and segregation, engendering inequitable access to quality medical care and public facilities, (b) institutional barriers to toileting autonomy in educational and occupational settings, promoting unhealthy voiding habits, (c) internalized expectations of Black women's stereotyped role as family caregiver, compromising caregiver health, (d) lack of reliable information on bladder health, leading to unhealthy bladder behaviors, and (e) potentially stress-related comorbid chronic conditions and associated medication use, causing or exacerbating bladder problems.

Bladder health promotion interventions should address social-ecological and life course factors shaping Black women's bladder health, including social and structural barriers to accessing equitable health information and medical care.

Neurourology and urodynamics. 2024 Mar 07 [Epub ahead of print]

Beverly R Williams, Sonya S Brady, Elise C Levin, Oluwateniola Brown, Terri H Lipman, Heather Klusaritz, Jesse Nodora, Tamera Coyne-Beasley, Sara Putman, Sheila Gahagan, Kathryn L Burgio, Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium

Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA., Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA., Division of Community Health Services, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA., Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Division of Applied Sciences, Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA., Department of Pediatrics, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA., Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA., Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA., National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Besthesda, Maryland, USA.