Urinary incontinence prevalence: Results from the National Health and Nutrition Examination Survey

Purpose: We determined racial differences in urinary incontinence prevalence using the 2001-2004 National Health and Nutrition Examination Survey. Materials and Methods: The National Health and Nutrition Examination Survey is a continuous survey of a representative sample of the noninstitutionalized United States population. Demographic, self-reported racial/ethnic data and responses to the urinary portion of the survey were available for 4,229 women older than 20 years. We classified women by urinary incontinence subtype, that is pure stress incontinence, pure urge incontinence or mixed incontinence. Logistic regression models were fitted to investigate racial differences by type of urinary incontinence. Results: The sample was racially and ethnically diverse with 58% white nonHispanic, 22% Mexican-American and 20% black nonHispanic. Women were divided into 3 age ranges of 20 to 39 years old (36.3%), 40 to 59 (28%), and 60 years old or older (35.7%). Of the 4,229 women in the analytical sample 49.6% (2,098) reported urinary incontinence symptoms. Of those reporting incontinence symptoms 49.8% reported pure stress incontinence, 34.3% mixed incontinence and 15.9% pure urge incontinence. The odds of pure stress incontinence in white and Mexican-American women were approximately 2.5 times higher than in black women (OR 2.79, CI 2.1-3.8 and OR 2.5, CI 1.9-3.4) after adjusting for age, parity, body mass index and activity level. In contrast, black and Mexican-American women were more likely to report pure urge incontinence compared to white women (OR 0.6, CI 0.43-0.8). The prevalence of mixed incontinence was not significantly different among race/ethnicity groups. Conclusions: Race/ethnicity differences exist in self-reported urinary incontinence. While self-reported urinary incontinence is prevalent in United States community dwelling women regardless of racial background, the odds of pure stress incontinence are at least 2.5-fold higher in white and Mexican-American women than in black women.