Subjective Social Standing and Lower Urinary Tract Symptoms Among Black and White Women and Men in Four Regions of the United States

Objective: To examine whether subjective social standing is associated with lower urinary tract symptoms (LUTS) among women and men in the Coronary Artery Risk Development in Young Adults study, and whether racial identity modifies this association. Method: The MacArthur Scale of Subjective Social Status was administered in 2000–2001 and 2005–2006; scores were averaged. LUTS were assessed in 2012–2013. Separately for women and men, LUTS were regressed on perceived standing relative to others in one’s community and relative to others in the United States. Analyses were adjusted for race, age, parity (for women), benign prostatic hyperplasia (for men), objective indices of social standing, alcohol consumption, smoking, body mass index, and diabetes. The analytic sample consisted of 1,214 women and 874 men, aged 42–59 years. Results: Both higher subjective social standing in one’s community and relative to the United States were associated with a lower likelihood of experiencing more severe LUTS when the variables were entered individually into regression models with adjustment variables. When entered simultaneously, only higher perceived standing relative to others in the United States was associated with less severe LUTS among women, and only higher perceived standing relative to others in one’s community was associated with less severe LUTS among men. Racial identity did not modify associations. Conclusions: Consistent with literature on other health outcomes, lower social standing relative to others in one’s community or the United States was associated with LUTS. Research is needed to understand the mechanisms by which perceptions of lower social standing may influence the development, maintenance, or worsening of LUTS.