Health Disparities and Overactive Bladder: Bridging the Gap

Overactive bladder (OAB) affects ~ 33 million Americans. Most studies enroll predominantly educated, non-Hispanic White women, limiting understanding of how social determinants, race/ethnicity, and structural inequities influence OAB burden and treatment. Evidence suggests disparities in prevalence, diagnosis, and guideline-based therapy reflect social and structural factors rather than biology.

Literature from 2010 to 2025 notes higher OAB burden among Black, Hispanic, and lower-income women. Structural barriers (e.g., limited specialist access, high costs, restrictive insurance, and competing needs) reduce care-seeking and therapy adherence. Social and cultural factors, including stigma, mistrust, low health literacy, and language barriers, further limit engagement. Minority and low-income patients utilize pharmacologic and minimally invasive therapies less frequently despite greater symptom severity. Frailty affects treatment selection but does not appear to impact benefit. Strategies to address disparities include inclusive research, culturally tailored education, digital and community-based care, and patient navigators.

OAB disparities reflect intersecting structural, socioeconomic, and cultural factors. Equity requires inclusive research, responsive education, expanded access, and policy reform to address structural determinants.

The online version contains supplementary material available at 10.1007/s11884-026-00811-2.