Differences in continence rates in individuals with spina bifida based on ethnicity

Kathryn A. Smith, Tiebin Liu, Kurt A. Freeman, Cecily Betz, Gerald H. Clayton, Heidi Castillo, Jonathan Castillo, Duong Tu, Alexander Van Speybroeck, William O. Walker

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


BACKGROUND: Ethnic disparities in continence rates in spina bifida (SB) have been studied regionally but not nationally. National SB Patient Registry (NSBPR) data were analyzed to explore differences in prevalence of bowel and bladder continence and interventions between Hispanics/Latinos and others. METHODS: Participants 5 to 21 years were categorized into Hispanic/Latino and non-Hispanic/non-Latino. Bladder/bowel continence was defined as dry/no involuntary stool leakage during the day or none/6 monthly incontinence. Chi-square test, Wilcoxon Two Sample Test, and generalized estimating equation (GEE) were used for statistical analysis. RESULTS: Twenty-five percent of the 4,364 patients were Hispanic/Latino. At their most recent clinic visit, Hispanics/Latinos demonstrated lower rates of urinary continence (38.6% vs. 44.9%; p = 0.0003), bowel continence (43.9% vs. 55.8%, p <0.0001), private insurance (p < 0.0001), bowel (p < 0.0001) or bladder surgeries (p = 0.0054), and more vesicostomies (p = 0.0427) compared to others. In multiple GEE models, Hispanic/Latino participants demonstrated lower odds of bowel continence as compared to non-Hispanic/non-Latino participants (estimated odds ratio, 0.82, 95% CI, 0.72–0.94, p = 0.0032). CONCLUSIONS: After controlling for covariates, Hispanics/Latinos with SB are less likely to report bowel continence. Clinicians are encouraged to consider the risk of negative health disparities for Hispanic patients with SB and work to mitigate this risk.

Original languageEnglish (US)
Pages (from-to)361-368
Number of pages8
JournalJournal of Pediatric Rehabilitation Medicine
Issue number4
StatePublished - 2019


  • Hispanic
  • Latino
  • Spina bifida
  • continence
  • health disparities
  • myelomeningocele

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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