Ethnic differences between Maori, Pacific Island and European New Zealand women in prevalence and attitudes to urinary incontinence.
OBJECTIVE
To assess the prevalence of urinary incontinence in New Zealand women of European, Maori and Pacific Island descent aged 18 years and over.


METHODS
A questionnaire, designed to be self administered, was sent to a group of 1028 women selected at random from the electoral roll in central Wellington. Incontinence was defined as any involuntary loss of urine. If present, details were sought regarding the occurrence, type, and severity of the incontinence so that the prevalence and nature of the problem within ethnic groups could be determined.


RESULTS
The prevalence for Maori women (46.8%) was significantly greater than for either Pacific Island (29.2%) or European women (31.2%) (chi 2 = 14.02, p = 0.001). Increasing age, and parity were associated with increasing prevalence of incontinence for all ethnic groups. Of the incontinent women, 9% were continually incontinent, 28% once or more daily, and 37% more than twice monthly. A further 26% were incontinent less than twice monthly. The most reported type of incontinence was stress incontinence (48% of incontinent women), with 27% reporting urge incontinence, and 21% a mixed picture of stress and urge. There was no significant difference in the frequency of these symptoms between the different ethnic groups. Fifty per cent of incontinent women reported wanting help for their urinary problems, but only one third had sought medical assistance, with many regarding incontinence as a normal occurrence.


CONCLUSIONS
Urinary incontinence is common in New Zealand women irrespective of ethnic group. The low proportion of women seeking medical assistance emphasises the need for much greater awareness and public education of what is largely a treatable clinical problem. Urinary incontinence is estimated to affect more than one quarter of the female population. The prevalence varies according to different age groups, and although it is recognised that incontinence is more common in the elderly, a significant number are young with nearly 20% of female children experiencing episodes of urinary leakage. The medical, personal and social impact of urinary incontinence is substantial, but surprisingly it is largely ignored, both by women with the condition, and by those providing health services to them such that it has been described as 'the hidden epidemic'. In New Zealand, research has been carried out on the prevalence of urinary incontinence and reasons for not seeking treatment in the European community, but the other major ethnic groups in New Zealand (Maori and Pacific Island) have not been investigated. The aim of this study was to assess the prevalence of urinary incontinence in these ethnic groups and to determine any differences to the prevalence of incontinence in European women in a similar socioeconomic environment. In addition, it was hoped to obtain some understanding of the attitudes of the women in each group to incontinence and their perception of the currently available treatments and medical services.
Lara
C
C
University Department of Surgery, Wellington School of Medicine.
Nacey
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005060:Europe / Q000208:ethnology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010139:Pacific Islands / Q000208:ethnology; D010298:Parity; D011247:Pregnancy; D015995:Prevalence; D014549:Urinary Incontinence / Q000208:ethnology* / Q000523:psychology; D044465:White People