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Are seasonal and income variations accountable for bowel and bladder dysfunction symptoms in children?
Israel Franco1, Jacob Franco2, Sylvia Harding3
1New York Medical College, Valhalla, New York.
Insights
Lower urinary tract symptoms (LUTS) vary significantly between socioeconomic groups. High-income children present with urgency and frequency, while lower-income children experience incontinence and infections.
Area of Science:
- Pediatric Urology
- Socioeconomic Determinants of Health
- Lower Urinary Tract Symptoms (LUTS)
Background:
- Illnesses can exhibit seasonal variations.
- Socioeconomic status influences health outcomes, potentially due to healthcare access, environmental, or occupational factors.
- Investigating LUTS in relation to socioeconomic status and season is warranted.
Purpose of the Study:
- To determine if there are differences in the presentation of lower urinary tract symptoms (LUTS) among patients from different socioeconomic groups and across seasons.
- To analyze the correlation between socioeconomic status and specific LUTS.
Main Methods:
- A retrospective review of electronic medical records from 10 offices across a wide geographic area was conducted.
- Data from 13,346 patients (6,010 males, 6,957 females) over 5 years were analyzed.
- Patients were categorized based on socioeconomic indicators, and presenting LUTS were documented.
Main Results:
- Males were older at presentation than females (8.1 vs. 6.9 years) with similar median incomes.
- Urinary tract infections (UTIs) and dysuria were more common in females and males, respectively.
- Urgency and frequency correlated with high-income groups, while urinary incontinence (UI), urgency urinary incontinence (UUI), fecal soiling (FS), and UTIs were more prevalent in lower-income (high school) groups. Constipation was more prevalent in the professional (high-income) group.
Conclusions:
- Significant differences in LUTS exist between socioeconomic groups, particularly concerning urgency, frequency, and constipation in high-income children.
- Lower-income children are more frequently associated with UI, UUI, UTIs, and FS.
- These findings highlight the impact of socioeconomic factors on pediatric LUTS presentation.
Aims:
Certain illnesses tend to occur more commonly at certain times of the year. It is also known that individuals of different socioeconomic groups have a predilection for physical ailments that in some cases may be related to poor access to healthcare or may be related to environmental or work related causes. We hypothesized that there may be a difference between patients from season to season and from different socioeconomic groups and their presenting lower urinary tract symptoms (LUTS).
Methods:
We reviewed our electronic medical record going back for 5 years, selecting out all patients who presented to all 10 of our offices in a wide geographic area that covers 22 million people of all races and income levels in the Tristate area of New York.
Results:
We identified 13,346 patients, 6,010 males and 6,957 females, and 379 were excluded for not meeting age inclusion criteria. The descriptive statistics based on age, median income for both males and females can be found in Tables I, II, III, and IV, respectively. Of note, males were older than females at presentation (8.1 vs. 6.9 years) with no difference in median incomes between families. There were more UTIs in females and more dysuria complaints in males. Urinary incontinence also appeared to be more prevalent in females than males, while males had more issues with fecal soiling than the females. What was obvious was that urgency and frequency was positively correlated with high income groups. On the other hand urinary incontinence represented either by itself or combined with UUI was more prevalent in the high school group. Fecal soiling was also more prevalent in the high school group. UTIs were more prevalent in the high school group but surprisingly there was no difference in patients that were not able to empty their bladders. Conversely we found that constipation was more prevalent in the professional group than in the other groups which is the opposite of the FS findings. Lastly dysuria appeared to be more prevalent in the P group.
Conclusions:
It is clear that there are marked differences in the results between high school income and professional income groups in particular with the U and F, along with C which correlate with high income professionals' children. UUI, UI, UTI, along with FS are associated with high school income parents. Neurourol. Urodynam. 36:148-154, 2017. © 2015 Wiley Periodicals, Inc.
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