Understanding the Impact of Rurality: Outcomes for Women with Urinary Incontinence

To evaluate the burden of social drivers of health in rural women with urinary incontinence (UI) across quality of life, financial, and psychosocial domains compared to their non-rural counterparts.

Adult women with any type and severity of UI were recruited from outpatient urology clinics and electronically via ResearchMatch from the surrounding community between December 2022 and May 2023. Participants were asked to complete anonymous questionnaires in REDCap assessing sociodemographics (including zip code to determine rurality), urinary symptoms, unmet social needs, and disease burden. Rural and non-rural participants were compared, and multivariable logistic regression was used to assess associations between individual unmet social needs and rurality.

Of the 1,006 women with UI in our cohort, 15.9% lived in a rural area. Rural women differed significantly in sociodemographics from non-rural women (Table 1). Despite similar UI severity between groups, rural women reported a greater burden of unmet social needs, worse LUTS-specific QOL, and greater financial toxicity and psychosocial burden as compared to non-rural women.

In this cohort of women with UI, rural women face a compounding set of psycho-socio-financial burdens of their urinary symptoms, despite similar UI severity as compared to non-rural women. Effective care for this population requires a multi-disciplinary approach beyond the clinic by integrating telehealth, social work, financial counseling, and community-based resources into management of UI.