• Jay H Fowke, Heather Munro, Lisa B Signorello, William J Blot, David F Penson, and Urologic Diseases of America Project.
• Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. jay.fowke@vanderbilt.edu
• J Gen Intern Med. 2011 Nov 1; 26 (11): 130513101305-10.

BackgroundA higher prevalence of moderate or severe lower urinary tract symptoms (LUTS) has been reported among African Americans, but the separate effects of race and socioeconomic status (SES) on LUTS severity are unclear.ObjectiveWe investigated the roles of education, income, marital status, and source of health insurance on LUTS reporting among black and white U.S. men.DesignA prospective cohort within the Southern Community Cohort StudyMain MeasuresThe International Prostate Symptom Score (IPSS) was completed during follow-up by 2488 white men and 4188 black men. Multivariable linear and logistic regression methods were used to compare IPSS scores and LUTS severity by race and SES after adjusting for age, duration of follow-up, benign prostatic hyperplasia (BPH) treatment, source of recruitment, smoking status, BMI, mode of follow-up ascertainment, and prior diagnosis of hypertension, diabetes, or hypercholesterolemia.Key ResultsOverall IPSS scores and the prevalence of moderate/severe LUTS were not significantly associated with race. Instead, higher IPSS scores were significantly associated (p < 0.05) with a lower income, marital status, and source of insurance. Education was also marginally associated with IPSS scores (p = 0.06) among black men. Furthermore, moderate/severe LUTS onset was significantly associated with a household income less than $15,000/year (OR = 1.56 (1.23, 1.96)) and having private health insurance (OR = 0.79 (0.67, 0.93)).ConclusionsSocial or behavioral factors related to SES affect LUTS reporting, and suggests a potential affect on BPH diagnosis.

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