The utility of social media continues to expand in today’s day and age. It has become one of the fastest growing avenues for interpersonal communication and has changed the way information is shared and obtained throughout our population.¹ Health care in particular has benefitted from the existence of applications like YouTube and TikTok. Providers are using these social media outlets to educate our population on disease course and prevention. It allows them to tailor information to access a greater audience.² Patients are also finding benefits within social media because it gives them an outlet to share their medical experiences and generate social and emotional support from their peers.^2,3 Despite these benefits, the freedom of content creation on these platforms opens the door for bias and misinformation.

Urology has seen an increase in social media use.⁴ Content creation in this space is broad, covering topics like urinary tract infections, genitourinary malignancies, and overactive bladder.^4,5 Overactive bladder is of particular interest due to a large prevalence within our population.^5,6 Recent studies show that overactive bladder affects 33% of women and 16% of men.⁶ When stratified by ethnicity, overactive bladder was more prevalent in African American men (20.2%) compared to Hispanic (18.1%) and White men (14.6%).⁶ For women, overactive bladder was more prevalent in African American women (32.6%) compared to Hispanic (29%) and White women (29.4%).⁶ Despite these findings, underrepresentation of non-White ethnicities remains in the scholarly literature on overactive bladder.⁵ However, disparity in race and ethnicity on this topic has yet to be explored in the social media space.

At the University of Maryland, we collected overactive bladder data from content produced on YouTube and TikTok on February 13, 2022. On YouTube we searched the term “overactive bladder” and analyzed 92 videos. On TikTok we used an application program interface and analyzed 155 videos containing the hashtag #overactivebladder. Content that was not related to overactive bladder, surgical technique videos not intended for patients, non-English, longer than 10 minutes, or lacked both text and audio were excluded from our data.

Female creators on YouTube produced 51.1% of overactive bladder content while 27.2% and 21.7% were produced by males and individuals who did not identify as male or female. Furthermore, 54.3% of this YouTube content was produced by White creators while 1.1% was produced by African American, 7.6% produced Asian/Middle Eastern, and 17.4% produced by multi-race creators. On TikTok female creators produced 81.3% of overactive bladder content while 12.9% and 5.8% were produced by males and individuals who did not identify as male or female. Lastly, 66.5% of this TikTok content was produced by White creators while 8.4% was produced by African American, 5.2% produced by Asian/Middle Eastern, and 12.9% produced by multi-race creators.

The representation of race and gender in overactive bladder content on YouTube and TikTok varies and could be influenced by factors such as the creators’ personal experiences, cultural background, and target audience.⁷ Some creators may focus on addressing overactive bladder from a gender-specific perspective, while others may provide a more general or inclusive approach. Regardless, the existing disparity in race and ethnic representation on overactive bladder in scholarly literature is also seen in social media content. Our findings suggest that a significant portion of social media content on overactive bladder is being produced by female creators and White creators.

Overactive bladder is a condition that is heavily influenced by social determinants. Food insecurity, financial strain, employment, and difficulty maintaining concentration are all factors that can influence the symptoms one experiences.⁸ Recognizing these weaknesses in health care content is important because this form of information is consumed by a wide audience. Platforms like YouTube and TikTok are great for public education, and they impact the access to information/resources for individuals affected by conditions like overactive bladder. Underrepresentation can lead to a lack of awareness and understanding of overactive bladder in these communities. In addition to this, inclusive representation can help promote a better understanding of the condition and positively impact individuals from diverse backgrounds by improving literacy, creating strong support networks, and further eliminating barriers between patients and providers.

Overall, it is essential to promote diverse and inclusive representation in health content on social media platforms, including overactive bladder, to ensure that individuals from all backgrounds have access to accurate and relevant information.