Noncancerous Genitourinary Conditions as a Public Health Priority: Conceptualizing the Hidden Burden

Publication Date

8-1-2022

Document Type

Article

Publication Title

Urology

Volume

166

DOI

10.1016/j.urology.2021.08.040

First Page

39

Last Page

49

Abstract

Objective: To provide a conceptual framework to guide investigations into burdens of noncancerous genitourinary conditions (NCGUCs), which are extensive and poorly understood. Methods: The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop of diverse, interdisciplinary researchers and health professionals to identify known and hidden burdens of NCGUCs that must be measured to estimate the comprehensive burden. Following the meeting, a subgroup of attendees (authors of this article) continued to meet to conceptualize burden. Results: The Hidden Burden of Noncancerous Genitourinary Conditions Framework includes impacts across multiple levels of well-being and social ecology, including individual (ie, biologic factors, lived experience, behaviors), interpersonal (eg, romantic partners, family members), organizational/institutional (eg, schools, workplaces), community (eg, public restroom infrastructure), societal (eg, health care and insurance systems, national workforce/economic output), and ecosystem (eg, landfill waste) effects. The framework acknowledges that NCGUCs can be a manifestation of underlying biological dysfunction, while also leading to biological impacts (generation and exacerbation of health conditions, treatment side effects). Conclusion: NCGUCs confer a large, poorly understood burden to individuals and society. An evidence-base to describe the comprehensive burden is needed. Measurement of NCGUC burdens should incorporate multiple levels of well-being and social ecology, a life course perspective, and potential interactions between NCGUCs and genetics, sex, race, and gender. This approach would elucidate accumulated impacts and potential health inequities in experienced burdens. Uncovering the hidden burden of NCGUCs may draw attention and resources (eg, new research and improved treatments) to this important domain of health.

Funding Number

1K23AG057813

Funding Sponsor

National Institutes of Health

Comments

Full author list: Sonya S. Brady, Tamara G. Bavendam, Christine K. Bradway, Britt Conroy, Annemarie Dowling-Castronovo, Cynthia Neill Epperson, Adonis K. Hijaz, Ryan S. Hsi, Karen Huss, Michelle Kim, Jason Lazar, Richard K. Lee, Christine K. Liu, Christine N. Loizou, Saadia Miran, Lona Mody, Jenna M. Norton, William Stuart Reynolds, Siobhan Sutcliffe, Nicole Zhang, James A. Hokanson

Department

Nursing

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