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

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 (NIDDK) 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 (i.e., biologic factors, lived experience, behaviors), interpersonal (e.g., romantic partners, family members), organizational/institutional (e.g., schools, workplaces), community (e.g., public restroom infrastructure), societal (e.g., health care and insurance systems, national workforce/economic output), and ecosystem (e.g., 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). Conclusions 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 (e.g., new research and improved treatments) to this important domain of health.