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Health disparities in urogynecology significantly impact patient outcomes, particularly in underserved communities. Socioeconomic status, race, ethnicity, and geographic location can affect access to care, treatment quality, and overall pelvic health outcomes. Addressing these disparities is critical for ensuring equitable care. By understanding the social determinants of health, fostering cultural competence, and promoting inclusive research, we can better educate providers and improve healthcare delivery for all women, regardless of background.

Health Disparities in Women's Health Videos

This video series explores key issues in women's health, focusing on disparities in care and outcomes. Experts discuss solution-based approaches, leadership roles, and patient-centered strategies to address health inequities and improve patient care.

Video (11 min) | McMaster University
 
NIH Health Disparities Interest Group and NIMHD DIR joint seminar (57 min) | NIH
 
Panel Discussion (57 min) | Milken Institute
 
Webinar (143 min) | Office for Health Equity and Inclusion (OHEI) at Michigan Medicine
 
Forbes Report (19 minutes) | McKinsey Health Institute
 
 

Guidelines, Toolkits, & Best Practices

Guidelines from professional organizations (e.g., AUGS, ACOG) that address health equity in urogynecology.

 

Academic Literature & Research Studies

Peer-reviewed journals and articles that explore disparities in urogynecologic care, outcomes, and access, as well as research on social determinants of health and their impact on pelvic health.

General Urogyn

  1. Gonzalez, Daniel C., et al. "A systematic review of racial/ethnic disparities in female pelvic floor disorders." Urology 163 (2022): 8-15. https://pubmed.ncbi.nlm.nih.gov/34627869/
  2. Mckay, Elishia R., et al. "Representation of minority groups in key pelvic floor disorder trials." Urogynecology 27.10 (2021): 602-608. https://pubmed.ncbi.nlm.nih.gov/34554142/
  3. Brandon, C., et al. "77: Are we colorblind? A review of racial and/or ethnic representation within the Pelvic Organ Prolapse practice bulletin." American Journal of Obstetrics & Gynecology 222.3 (2020): S820-S821.
  4. Gurayah, Aaron A., et al. "Pelvic Floor Disorders Among Minority Women: Differences in Prevalence, Severity and Health-Related Social Needs." Urology 186 (2024): 147-153. https://pubmed.ncbi.nlm.nih.gov/38395073/
  5. MacNevin, Wyatt, Christopher Bitcon, and Ashley Cox. "Social Disparities in the Diagnosis and Care of Lower Urinary Tract Dysfunction." Current Bladder Dysfunction Reports 17.4 (2022): 271-278.
  6. Rortveit, Guri, et al. "Urinary incontinence, fecal incontinence and pelvic organ prolapse in a population-based, racially diverse cohort: prevalence and risk factors." Urogynecology 16.5 (2010): 278-283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976795/

SUI

  1. Mckellar, Keneta, and Nitya Abraham. "Prevalence, risk factors, and treatment for women with stress urinary incontinence in a racially and ethnically diverse population." Neurourology and urodynamics 38.3 (2019): 934-940. https://pubmed.ncbi.nlm.nih.gov/30690749/
  2. Gonzalez, Gabriela, et al. "Underrepresentation of racial and ethnic diversity in research informing the American urological association/society of urodynamics, female pelvic medicine & urogenital reconstruction stress urinary incontinence guideline." Urology 163 (2022): 16-21. https://pubmed.ncbi.nlm.nih.gov/34536408/
  3. Thom, David H., et al. "Differences in prevalence of urinary incontinence by race/ethnicity." The Journal of urology 175.1 (2006): 259-264. https://pubmed.ncbi.nlm.nih.gov/16406923/
  4. Akbar, Aelia, et al. "Racial differences in urinary incontinence prevalence and associated bother: the Multi-Ethnic Study of Atherosclerosis." American journal of obstetrics and gynecology 224.1 (2021): 80-e1. https://pubmed.ncbi.nlm.nih.gov/32697955/
  5. Boyd, Brittni, et al. "Treatment of Stress Urinary Incontinence: Does Race Matter?." Urogynecology (2022): 10-1097. https://pubmed.ncbi.nlm.nih.gov/38710019/

POP

  1. Mou, Tsung, et al. "Prevalence of pelvic organ prolapse among US racial populations: A systematic review and meta‐analysis of population‐based screening studies." Neurourology and Urodynamics 40.5 (2021): 1098-1106. https://pubmed.ncbi.nlm.nih.gov/33834519/
  2. Brandon, Caroline A., et al. "Racial and ethnic representation in primary research contributing to pelvic organ prolapse treatment guidelines." International Urogynecology Journal 32 (2021): 2959-2967. https://pubmed.ncbi.nlm.nih.gov/34570246/
  3. Northington, Gina M., and Steven Minaglia. "Diversity in pelvic floor disorders research: A matter of equity and inclusion." Urogynecology 29.1 (2023): 1-4. https://pubmed.ncbi.nlm.nih.gov/36548100/
  4. Brazell, Hema D., David M. O'Sullivan, and Paul K. Tulikangas. "Socioeconomic status and race as predictors of treatment-seeking behavior for pelvic organ prolapse." American journal of obstetrics and gynecology 209.5 (2013): 476-e1. https://pubmed.ncbi.nlm.nih.gov/23673228/
  5. Ford, Alexcis T., et al. "Racial differences in pelvic organ prolapse symptoms among women undergoing pelvic reconstructive surgery for prolapse." Urogynecology 25.2 (2019): 130-133. https://pubmed.ncbi.nlm.nih.gov/30807414/
  6. Ackenbom, Mary F., et al. "Crucial Considerations on Race/Ethnicity and Incidence of Pelvic Organ Prolapse in Midlife Women: The Study of Women’s Health Across the Nation." Journal of Women's Health 33.8 (2024): 1010-1011. https://pubmed.ncbi.nlm.nih.gov/39042583/
  7. Rozycki, Sarah K., et al. "Healthcare disparities and pelvic organ prolapse operative complications: a nationwide analysis." International Urogynecology Journal 34.12 (2023): 2893-2899. https://pubmed.ncbi.nlm.nih.gov/37548744/
  8. Brown, Oluwateniola, et al. "Racial disparities in complications and costs after surgery for pelvic organ prolapse." International Urogynecology Journal (2022): 1-11. https://pubmed.ncbi.nlm.nih.gov/33755740/
  9. Yadav, Ghanshyam S., et al. "Health care disparities in surgical management of pelvic organ prolapse: a contemporary nationwide analysis." Urogynecology 28.4 (2022): 207-212. https://pubmed.ncbi.nlm.nih.gov/35443256/

 

Chronic pelvic pain

  1. Nguyen, Lee Huynh, et al. "Disparities in pain management." Anesthesiology Clinics 41.2 (2023): 471-488. https://pubmed.ncbi.nlm.nih.gov/37245951/
  2. Labuski, Christine M. "A black and white issue? Learning to see the intersectional and racialized dimensions of gynecological pain." Social Theory & Health 15 (2017): 160-181.
  3. Adams, Olivia R., Amanda N. Gesselman, and Margaret Bennett-Brown. "Centering Women of Color: Chronic Vulvovaginal Pain (CVVP) Communication." Social Sciences 13.5 (2024): 265.
  4. Dallas, Kai B., et al. "Demographic differences and disparities in the misdiagnosis of interstitial cystitis/bladder pain syndrome in a national cohort of VA patients." Urology 163 (2022): 22-28. https://pubmed.ncbi.nlm.nih.gov/34348123/

 

Prolapse surgery

  1. Winkelman WD, Hacker MR, Anand M, Lefevre R, Richardson ML. Racial and Ethnic Disparities in Obliterative Procedures for the Treatment of Vaginal Prolapse. Female Pelvic Med Reconstr Surg. 2021 Dec 1;27(12):e710-e715. doi: 10.1097/SPV.0000000000001116. PMID: 34807885; PMCID: PMC8812327. https://pubmed.ncbi.nlm.nih.gov/34807885/
  2. Yadav GS, Rutledge EC, Nisar T, Xu J, Rozycki SK, Muir T, Antosh DD. Health Care Disparities in Surgical Management of Pelvic Organ Prolapse: A Contemporary Nationwide Analysis. Female Pelvic Med Reconstr Surg. 2022 Apr 1;28(4):207-212. doi: 10.1097/SPV.0000000000001173. PMID: 35443256. https://pubmed.ncbi.nlm.nih.gov/35443256/
  3. Rodríguez D, Goueli R, Lemack G, Zimmern P, Carmel M. Racial and Ethnic Disparities in Pelvic Organ Prolapse Surgery in the United States: An Analysis of the ACS-NSQIP Clinical Registry. Urology. 2023 Apr;174:70-78. doi: 10.1016/j.urology.2023.01.021. Epub 2023 Feb 9. PMID: 36764490.
  4. Boyd, Brittni A.J. et al. Racial and ethnic differences in reconstructive surgery for apical vaginal prolapse American Journal of Obstetrics & Gynecology, Volume 225, Issue 4, 405.e1 - 405.e7.

 

Urge/Urinary incontinence

  1. Brown O, Simon MA. Applying a Health Equity Lens to Urinary Incontinence. Clin Obstet Gynecol. 2021 Jun 1;64(2):266-275. doi: 10.1097/GRF.0000000000000613. PMID: 33859095; PMCID: PMC8552501. https://pubmed.ncbi.nlm.nih.gov/33859095/
  2. Sundqvist C, Li X, Sundquist K, Jansåker F. Sociodemographic Disparities and Parity in Relation to Urinary Incontinence: A Nationwide Primary Healthcare Cohort Study (1997-2018). J Clin Med. 2022 Jan 19;11(3):496. doi: 10.3390/jcm11030496. PMID: 35159948; PMCID: PMC8836927. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836927/
  3. Blanco Gutiérrez V, Hundley VA, Way S. The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review. Journal of Transcultural Nursing. 2023;34(4):288-300. doi:10.1177/10436596231172205.
  4. Tellechea L, Zuo S, Kohn JR, Fazzari MJ, Eisenberg R, Lee J, et al. The Effect of Social Determinants of Health on Overactive Bladder Symptom Severity. Journal of Urology [Internet]. 2021 May 1 [cited 2024 Sept 8]; 205 (5): 1415-20. Available from: https://doi.org/10.1097/JU.0000000000001545

 

Pelvic floor disorders

  1. Megahed, N. et al. Racial and ethnic disparities in pelvic floor disorder awareness. American Journal of Obstetrics & Gynecology, Volume 226, Issue 3, S1299 - S1300. https://www.ajog.org/article/S0002-9378(21)02746-0/fulltext
  2. Nicola-Ducey, Lauren MD∗; Nolan, Olivia MD∗; Cichowski, Sara MD∗; Osmundsen, Blake MD†. Racial and Ethnic Disparities in Sacrocolpopexy Approach. Urogynecology ():10.1097/SPV.0000000000001546, July 8, 2024. https://pubmed.ncbi.nlm.nih.gov/38990736/
  3. Nauheim, J., McKay, E., Laudano, M. et al. Healthcare Disparities in the Treatment of Pelvic Floor Disorders. Curr Bladder Dysfunct Rep 15, 135–141 (2020). https://doi.org/10.1007/s11884-020-00598-w
  4. Ackenbom MF, Carter-Brooks CM, Soyemi SA, Everstine CK, Butters MA, Davis EM. Barriers to Urogynecologic Care for Racial and Ethnic Minority Women: A Qualitative Systematic Review. Urogynecology (Phila). 2023 Feb 1;29(2):89-103. https://pubmed.ncbi.nlm.nih.gov/36735420/
  5. Deportp KA, DeAndrade S, Crawford K, Zhou B, Tenggardjaja C. PD24-09 Are There Socioeconomic disparities in Pelvic Organ Prolapse Surgery in a managed care setting? Journal of Urology [Internet]. 2024 May 19[ cited 2024 Sept 8]; 211 (5s):e534. Available from: https://doi.org/10.1097/01.JU.0001008840.07763.8d.09
  6. https://education.augs.org/AssetListing/AUGS-FPMRS-Webinar-The-Nature-and-Impact-of-Racial-Disparities-in-Urogynecology-On-Demand-5839/AUGS-FPMRS-Webinar-26104

(Neha Sudol, MD “The nature and impact of Racial Disparities in Urogynecology.” AUGS Webinar Educational Series 11/2021)

 

Genital Fistula

  1. Ngongo CJ, Raassen TJIP, Mahendeka M, Lombard L, van Roosmalen J, Temmerman M. A retrospective review of genital fistula occurrence in nine African countries. BMC Pregnancy Childbirth. 2022 Oct 4;22(1):744. doi: 10.1186/s12884-022-05051-w. PMID: 36195839; PMCID: PMC9531465. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531465/
  2. Keya, K.T., Sripad, P., Nwala, E. et al. “Poverty is the big thing”: exploring financial, transportation, and opportunity costs associated with fistula management and repair in Nigeria and Uganda. Int J Equity Health 17, 70 (2018). https://doi.org/10.1186/s12939-018-0777-1
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