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Introduction and Hypothesis <p>To investigate the association between a composite measure of adverse social determinants of health (SDOH) and overactive bladder (OAB) among US adults, and to assess the potential role of depression in this relationship.</p> Methods <p>We conducted a cross-sectional analysis of adult participants (≥ 18&#xa0;years) from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). A composite SDOH score (range 0–8) was derived from eight adverse conditions across economic, educational, healthcare, housing, and social domains. OAB was defined using the Overactive Bladder Symptom Score (OABSS ≥ 3). Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9 ≥ 10). Survey-weighted multivariable logistic regression models were used to examine associations, adjusting for covariates. Mediation analysis quantified the proportion of the SDOH-OAB association explained by depression.</p> Results <p>Among 27,429 participants (weighted <i>n</i> = 191.7 million), the prevalence of OAB was 19.3%. In the fully adjusted model, each 1-unit increase in the SDOH score was associated with 16% higher odds of OAB (OR 1.16; 95% CI 1.14–1.18). A clear dose–response relationship was observed across SDOH categories (<i>P</i>&#xa0;for trend &lt; 0.01). Key individual SDOH components, including unemployment, poverty, and food insecurity, were independently associated with OAB. Depression accounted for a substantial proportion of the total association between SDOH and OAB. The positive SDOH-OAB association was consistent across most subgroups, and findings were robust in sensitivity analyses.</p> Conclusions <p>A greater burden of adverse social determinants of health is associated with an increased prevalence of OAB in US adults. This relationship may be partially explained by depression.</p>

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The Association Between Social Determinants of Health and Overactive Bladder in US Adults: Depression as a Potential Explanatory Factor

  • 期刊论文

  • 发表日期：

    2026年4月24日

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  • Renjie Huang,
  • Miao Huang,
  • Rui Zhang

摘要

Introduction and Hypothesis

To investigate the association between a composite measure of adverse social determinants of health (SDOH) and overactive bladder (OAB) among US adults, and to assess the potential role of depression in this relationship.

Methods

We conducted a cross-sectional analysis of adult participants (≥ 18 years) from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). A composite SDOH score (range 0–8) was derived from eight adverse conditions across economic, educational, healthcare, housing, and social domains. OAB was defined using the Overactive Bladder Symptom Score (OABSS ≥ 3). Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9 ≥ 10). Survey-weighted multivariable logistic regression models were used to examine associations, adjusting for covariates. Mediation analysis quantified the proportion of the SDOH-OAB association explained by depression.

Results

Among 27,429 participants (weighted n = 191.7 million), the prevalence of OAB was 19.3%. In the fully adjusted model, each 1-unit increase in the SDOH score was associated with 16% higher odds of OAB (OR 1.16; 95% CI 1.14–1.18). A clear dose–response relationship was observed across SDOH categories (P for trend < 0.01). Key individual SDOH components, including unemployment, poverty, and food insecurity, were independently associated with OAB. Depression accounted for a substantial proportion of the total association between SDOH and OAB. The positive SDOH-OAB association was consistent across most subgroups, and findings were robust in sensitivity analyses.

Conclusions

A greater burden of adverse social determinants of health is associated with an increased prevalence of OAB in US adults. This relationship may be partially explained by depression.