Association between social determinants of health and overactive bladder: a cross-sectional analysis of NHANES 2005-2018

Background The associations of individual and cumulative social determinants of health (SDoH) with overactive bladder (OAB) remain poorly understood. This study aimed to investigate these associations in U.S. adults.Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2005–2018 cycles. Self-reported SDoH were categorized according to the Healthy People 2030 framework. OAB was defined by self-reported symptoms of urge urinary incontinence and nocturia. Multivariate logistic regression models were used to assess the association between SDoH and OAB.Results Among the 21,075 participants, 3,536 were diagnosed with OAB. The following SDoH were positively associated with OAB in the overall population: unemployment (OR = 1.547, 95%CI: 1.362–1.756), family income-to-poverty ratio < 3 (OR = 1.182, 95%CI: 1.017–1.374), food insecurity (OR = 1.505, 95%CI: 1.306–1.735), educational attainment less than high school (OR = 1.471, 95%CI: 1.305–1.658), and no private health insurance (OR = 1.299, 95%CI: 1.159–1.455). Associations between individual SDoH factors and OAB risk varied by age and sex. Each additional unfavorable SDoH factor was associated with a 23.8% higher odds of OAB (OR = 1.238, 95%CI: 1.206–1.272). This relationship was linear and consistent across specific subgroups, with modifications by age (p for interaction = 0.003), sex (p for interaction = 0.007), and race (p for interaction = 0.019).Conclusions Unfavorable SDoH were associated with higher odds of OAB. Interventions targeting these social determinants, coupled with age- and sex-specific prevention and management strategies, may help reduce the burden of OAB.