Financial Strain Across 25 years and Men’s Lower Urinary Tract Symptoms

A Life Course Perspective

Bibliographic Data

ID21748655
AuthorsSonya S Brady (0000-0001-8660-9308, University of Minnesota, corresponding author), Alcides Arguedas (0000-0001-6299-052X, University of Minnesota), Andrés Arguedas (Division of Biostatistics & Health Data Science, University of Minnesota School of Public Health, MN, USA), Jared D Huling (0000-0003-0670-4845, University of Minnesota), Gerhard Hellemann (0000-0003-2449-7704, University of Alabama at Birmingham), Cora E Lewis (0000-0002-2301-5796, University of Alabama at Birmingham), David R Jacobs (0000-0002-7232-0543, University of Minnesota), Cynthia S Fok (0000-0003-1197-0099, University of Minnesota Medical Center), Stephen K Van Den Eeden (0000-0002-5599-8387, Kaiser Permanente), Alayne D Markland (0000-0002-6567-6744, Birmingham VA Medical Center)
Year2025
Volume19
Issue2
Pages15579883251330117-15579883251330117
Publication date2025-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAmerican Journal of Men s Health (JOURNAL)
Journal identifiersISSN: 1557-9883 • E-ISSN: 1557-9891
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/15579883251330117
PMID40162920
OpenAlexW4409086285
LanguageEN
References cited31

This research utilizes Coronary Artery Risk Development in Young Adults (CARDIA) cohort study data to examine whether financial strain is associated with subsequent lower urinary tract symptoms among men and whether healthcare barriers, health risk behaviors, and comorbid conditions explain this association. CARDIA recruited Black and White participants aged 18 to 30 years at baseline (1985–1986) from four United States cities. The analytic sample was comprised of men with complete data for analyses involving financial strain trajectories across 7 assessments ( n = 602) and mediation tests of data collected at 4 assessments ( n = 634). The outcome variable, assessed when the mean age of men was 50 years, was the American Urologic Association Symptom Index score, recoded into four symptom categories: none (6.3%); mild (62.6%), moderate (28.5%), and severe (2.6%). Symptom category was regressed on financial strain variables, adjusting for age, race, education, and self-reported benign prostatic hyperplasia. Regression analyses and structural equation modeling tested potential mediators. Compared to not being financially strained across early and midlife adulthood, experiencing more than one shift in financial strain was associated with 84% greater odds (95% confidence interval [1.24, 2.75]) of being categorized into a worse symptom category. Structural equation modeling showed that both difficulty receiving healthcare and depressive symptoms explained an association between difficulty paying for medical care and worse symptoms. Additional research is needed to confirm findings and examine other mechanisms that may further explain associations between financial strain and symptoms, such as stress responses. Accumulated evidence may inform future prevention interventions, including integrated healthcare approaches

Economics · Life course approach · Lower urinary tract symptoms · Prostate · Urinary system · Computer Science · Medicine · Pelvic floor disorders treatments · Psychology · Social Psychology · Urinary Bladder and Prostate Research · Urinary Tract Infections Management · Finance · Gerontology · Internal Medicine

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