HJAR Mar/Apr 2023

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2023 47 Iris Kennedy, APN Arkansas Urology A 2006 study of over 2,000 middle-aged or older females found that incontinence was highest among Hispanic women, with 35.9% of Hispanics surveyed experiencing episodes at least weekly. That compares to 29.6% of white women, and 25.2% of Black women. AfricanAmerican women, however, reported the highest levels of weekly “ur- gency”incontinence — the inability to reach a restroom after a sudden, urgent need to uri- nate — at 7.6%, compared to 5.8% of Hispanic women and 4.8% of white women. Though men experience incontinence at a lower rate than women, the problem still disproportionately impacts minority men. A2021 study of over 1,500 men between the ages of 50 and 98 years published in the journal of the American Urological Asso- ciation found that Blacks had the highest prevalence of urinary incontinence of any racial group in the study, at 13%. That com- pares to 11.3% of Hispanic men and just 6.8% of white men in the study. Erectile dysfunction Erectile dysfunction also disproportion- ately impacts minority men. One study of 2,100 men aged 40 and older found that the incidence of erectile dysfunction was highest in Black men, with 24.4% of African Americans in the study reporting ED. That compares to 21.9% of whites and 19.9% of Hispanics. The study found ED was often correlated with hypertension, which is sig- nificantly more common in African Ameri- can men than in whites (56% versus 48% respectively), and diabetes, which is much more common in both Blacks (12.1%) and Hispanics (11.8%) than in whites (7.4%). When it comes to talking with their doctor, studies show that minority men may be less likely to report ED than white men. A 2022 study looked at men who anonymously an- swered survey questions about their health. The study found that while 85.2% of whites were willing to answer questions related to ED, only 82.3% of Blacks and 81.2% of His- panics did so. This appears to show the impact cultural differences can have on reporting rates for ED, signaling Hispanic and Black men may be less comfortable discussing their history with ED even when given anonymity. It can likely be assumed that Hispanics and Blacks will exhibit even greater reluctance to dis- cuss their ED issues when talking face-to- face with a physician. Discussing these topics with minority patients is especially important in Arkan- sas, where there can be considerable cul- tural and financial barriers for those who need urologic care. For example, according to research by the non-profit Kaiser Fam- ily Foundation, 10.1% of African Americans and 26.4% of Hispanics in the state lack any form of health insurance coverage. But by knowing the facts about how these disorders disproportionately impact minority popula- tions in the state, you can help patients seek the care they need. n Iris Kennedy,APN, joinedArkansas Urology in 2008 as an advanced practice nurse. Kennedy started her medical training at the Julio Trigo Medical School in Havana, Cuba, in 1989. She graduated from the Uni- versity of Arkansas for Medical Science in 2005. Iris is amember of SigmaThetaTau Honor Society.Prior experience includes emergency medicine, general and vascular surgery, and gastroenterology. this disparity, many sources now recom- mend that Blackmen begin receiving regular screening for prostate cancer at 45 years old. Hispanic men, on the other hand, are 20% less likely to be diagnosed with prostate cancer than white men and less likely than white men to die from the disease, with 15.6 deaths per 100,000. Kidney cancer rates in the U.S. also show significant disparities between racial groups. African Americans, for example, are less likely to be diagnosed with or die from kid- ney cancer than whites. Hispanics, however, have an elevated risk. Kidney cancer is the fourth most commonly diagnosed cancer for Hispanics in the U.S., with 21.6 cases per 100,000 Hispanic men, and 12.1 per 100,000 Hispanic women. In addition, nephritis, ne- phrosis, and other kidney disorders are the ninth leading cause of death for Hispanics in the U.S., with a rate of 11.5 deaths per 100,000. Whites in the U.S. are around two times more likely to develop bladder cancer than AfricanAmericans. That said, long-term sur- vival rates for those with bladder cancer are worse for both Blacks and Hispanics when compared to whites. One study published in the journal Urology showed a five-year survival rate of 82.8% for whites diagnosed with bladder cancer, compared to 80.7% for Hispanics and only 70.2% for Blacks. While the reasons why are still up for debate, the study foundAfricanAmericans sought treat- ment after their cancer had progressed to a higher stage, which may account in part for the discrepancy in survival rates. Urinary incontinence Urinary incontinence is another condition that disproportionately impacts minorities.