Reproductive
Neighborhood Disadvantage and Menstrual Pain Among Black/ African-American Women Sydney Carolan* Sydney Carolan Ruth J. Geller Kristen Upson Quaker E. Harmon Chandra Jackson Anne Marie Jukic Ganesa Wegienka Lauren A. Wise Amelia K. Wesselink
Dysmenorrhea (severe menstrual pain) affects 16-29% of menstruating individuals. Stress is an established risk factor for dysmenorrhea and neighborhood environment can drive chronic stress; yet, there is little research on neighborhood context and menstrual health. We estimated the association of neighborhood disadvantage with menstrual pain among individuals in the Study of Environment, Lifestyle, and Fibroids. Participants self-identified as Black/ African-American, had an intact uterus, were aged 23-35 years, and lived in the Detroit, MI area in 2010-2012 (n=1693). Participants provided their residential address and data about the severity and impact of menstrual pain in the last year. We calculated a census tract level standardized neighborhood disadvantage score, a measure of disadvantage within the Detroit area, by linking addresses to 2011 American Community Survey data. We excluded participants who had no menses in the past year, or who used medication that could alter menstrual cycle frequency, for a final sample of 883. We fit age-adjusted log-binomial regression models to estimate prevalence ratios (PR) and 95% CIs for associations between neighborhood disadvantage scores (tertiles) and three menstrual pain outcomes: 1) menstrual pain is a “big problem”, 2) menstrual pain interferes “a lot” with daily activities, and 3) missed any days of work or home activities due to menstrual pain. Living in a more disadvantaged neighborhood was associated with a higher prevalence of menstrual pain outcomes. Relative to the lowest tertile, those in the highest tertile of neighborhood disadvantage were more likely to report menstrual pain being a big problem (PR=2.32, CI: 0.84-6.38), menstrual pain interfering a lot with daily activities (PR= 5.36, CI: 1.28-22.43), and missing any days of work or home activities due to menstrual pain (PR=2.02, CI: 0.95-4.30). Neighborhood disadvantage is associated with more severe menstrual pain that adversely impacts quality of life.
