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CARDIA recruited Black and White participants aged 18 to 30\u2009years at baseline (1985\u20131986) from four United States cities. The analytic sample was comprised of men with complete data for analyses involving financial strain trajectories across 7 assessments (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009602) and mediation tests of data collected at 4 assessments (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009634). The outcome variable, assessed when the mean age of men was 50\u2009years, was the American Urologic Association Symptom Index score, recoded into four symptom categories: none (6.3%); mild (62.6%), moderate (28.5%), and severe (2.6%). Symptom category was regressed on financial strain variables, adjusting for age, race, education, and self-reported benign prostatic hyperplasia. Regression analyses and structural equation modeling tested potential mediators. Compared to not being financially strained across early and midlife adulthood, experiencing more than one shift in financial strain was associated with 84% greater odds (95% confidence interval [1.24, 2.75]) of being categorized into a worse symptom category. Structural equation modeling showed that both difficulty receiving healthcare and depressive symptoms explained an association between difficulty paying for medical care and worse symptoms. Additional research is needed to confirm findings and examine other mechanisms that may further explain associations between financial strain and symptoms, such as stress responses. Accumulated evidence may inform future prevention interventions, including integrated healthcare approaches.\n                  <\/jats:p>","DOI":"10.1177\/15579883251330117","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T10:21:36Z","timestamp":1743416496000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Financial Strain Across 25\u2009years and Men\u2019s Lower Urinary Tract Symptoms: A Life Course Perspective"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8660-9308","authenticated-orcid":false,"given":"Sonya S.","family":"Brady","sequence":"first","affiliation":[{"name":"Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota Medical School, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Arguedas","sequence":"additional","affiliation":[{"name":"Division of Biostatistics &amp; Health Data Science, University of Minnesota School of Public Health, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared D.","family":"Huling","sequence":"additional","affiliation":[{"name":"Division of Biostatistics &amp; Health Data Science, University of Minnesota School of Public Health, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Hellemann","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham School of Public Health, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, University of Minnesota School of Public Health, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia S.","family":"Fok","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Minnesota Medical School, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen K.","family":"Van Den Eeden","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA"},{"name":"Department of Urology, University of California, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alayne D.","family":"Markland","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine and Birmingham VA Medical Center, Birmingham\/Atlanta GRECC, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"e_1_3_4_2_1","volume-title":"Incontinence","author":"Altman D.","year":"2023","unstructured":"Altman D., Cartwright R., Lapitan M. 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