Social determinants of health (SDOH) are defined by the Centers for Disease Control and Prevention (CDC) as “the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes” (Kim et al., 2022).
Whether we realize it or not, our social circumstances play a major role in our overall health and well-being. For example, people who live in affluent areas, have solid family and community support systems, and have access to high-quality health care services tend to have more favorable health outcomes than individuals who do not.
In fact, many studies have found associations between social factors and specific medical conditions, including female sexual dysfunction (FSD). FSD covers a broad range of sexual difficulties that women may have including painful intercourse, trouble reaching orgasm, and low sexual desire, arousal, or lubrication. One commonly used measure of FSD is sexual frequency, and low sexual frequency has been shown to be strongly associated with FSD after adjusting for other variables.
Given this context, the authors of a recent Journal of Sexual Medicine study endeavored to learn if there is an association between sexual frequency and socioeconomic status from a large nationally representative sample of women in the United States. The authors used data from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) to inform their research. Specifically, they focused on the participants’ reported family income and their responses to the survey question, “In the past 12 months, how many times have you had vaginal or anal sex?” The survey provided two options for answering this question: “0-11 times per year” and “more than 11 times per year.”
A total of 7,348 women between the ages of 20-59 years were included in the final analysis. The mean age of the participants was 38.4 years. To measure socioeconomic status, the researchers used the poverty to income ratio (PIR), which is a ratio of family income to poverty level, adjusted for family size and state of residence. PIR ranges from 1 to 5, with 1 indicating a family income at poverty level and 5 indicating a family income 5 times the annual poverty level.
After adjusting for other medical conditions and pertinent social and gynecologic factors such as marital status and history of pregnancy, the authors found an association between low sexual frequency and lower socioeconomic status.
Of the women included in the final sample, 26.3% reported having sex between 0-11 times per year and 73.7% reported having sex more than 11 times per year. The women who had a PIR of less than 2 were 92% more likely to report having sex 0-11 times per year than the women who had a PIR of greater or equal to 2.
Although low sexual frequency is not the only measure of FSD, the two are strongly linked. The authors offer several possible explanations for this finding including high stress, higher incidence of persistent infections, and worse overall health condition, all of which are factors associated with both lower economic status and FSD.
More research is required to determine the relationship between sexual frequency and socioeconomic status, but this study highlights the importance of screening for FSD in populations of lower socioeconomic status. Furthermore, such findings indicate the importance of having affordable treatment options for FSD so that women of all income levels can have access to these health services.