2023-09-28 14:46:10 +00:00
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abstract: 'IMPORTANCE Approximately 13\% of US adults are affected by visual
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disability, with disproportionately higher rates in groups impacted by
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certain social determinants of health (SDOH).
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OBJECTIVE To evaluate SDOH associated with severe visual impairment
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(SVI) to ultimately guide targeted interventions to improve ophthalmic
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health.
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DESIGN, SETTING, AND PARTICIPANTS This quality improvement study used
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cross-sectional data from a telephone survey from the Behavioral Risk
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Factor Surveillance System (BRFSS) that was conducted in the US from
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January 2019 to December 2020. Participants were noninstitutionalized
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adult civilians who were randomly selected and interviewed and
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self-identified as ``blind or having serious difficulty seeing, even
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while wearing glasses.{''''}
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EXPOSURES Demographic and health care access factors.
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MAIN OUTCOMES AND MEASURES The main outcomewas risk of SVI associated
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with various factors as measured by odds ratios (ORs) and 95\% CIs.
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Descriptive and logistic regression analyses were performed using theWeb
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Enabled Analysis Tool in the BRFFS.
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RESULTS During the study period, 820 226 people (53.07\% female)
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participated in the BRFSS survey, of whom 42 412 (5.17\%)
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self-identified as ``blind or having serious difficulty seeing, even
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while wearing glasses.{''''} Compared with White, non-Hispanic
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individuals, risk of SVI was increased among American Indian/Alaska
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Native (OR, 1.63; 95\% CI, 1.38-1.91), Black/African American (OR, 1.50;
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95\% CI, 1.39-1.62), Hispanic (OR, 1.65; 95\% CI, 1.53-1.79), and
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multiracial (OR, 1.33; 95\% CI, 1.15-1.53) individuals. Lower annual
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household income and educational level (eg, not completing high school)
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were associated with greater risk of SVI. Individuals who were out of
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work for 1 year or longer (OR, 1.78; 95\% CI, 1.54-2.07) or who reported
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being unable to work (OR, 2.90; 95\% CI, 2.66-3.16) had higher odds of
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SVI compared with the other variables studied. Mental health diagnoses
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and 14 or more days per month with poor mental health were associated
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with increased risk of SVI (OR, 1.87; 95\% CI, 1.73-2.02). Health care
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access factors associated with increased visual impairment risk included
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lack of health care coverage and inability to afford to see a physician.
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CONCLUSIONS AND RELEVANCE In this study, various SDOH were associated
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with SVI, including self-identification as being from a racial or ethnic
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minority group; low socioeconomic status and educational level;
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long-term unemployment and inability to work; divorced, separated, or
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widowed marital status; poor mental health; and lack of health care
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coverage. These disparities in care and barriers to health care access
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should guide targeted interventions.'
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affiliation: 'Patel, S (Corresponding Author), Vanderbilt Univ, Dept Ophthalmol, Med
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Ctr, 2311 Pierce Ave, Nashville, TN 37232 USA.
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Besagar, Sonya; Finn, Avni; Padovani-Claudio, Dolly Ann; Sternberg, Paul, Jr.; Patel,
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Shriji, Vanderbilt Univ, Dept Ophthalmol, Med Ctr, 2311 Pierce Ave, Nashville, TN
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37232 USA.
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Yonekawa, Yoshihiro, Thomas Jefferson Univ, Wills Eye Hosp, Mid Atlantic Retina,
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Philadelphia, PA 19107 USA.
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Sridhar, Jayanth, Bascom Palmer Eye Inst, Dept Ophthalmol, Miami, FL 33136 USA.'
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author: Besagar, Sonya and Yonekawa, Yoshihiro and Sridhar, Jayanth and Finn, Avni
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and Padovani-Claudio, Dolly Ann and Sternberg Jr., Paul and Patel, Shriji
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author-email: shriji.patel@vumc.org
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author_list:
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- family: Besagar
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given: Sonya
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- family: Yonekawa
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given: Yoshihiro
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- family: Sridhar
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given: Jayanth
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- family: Finn
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given: Avni
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- family: Padovani-Claudio
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given: Dolly Ann
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- family: Sternberg Jr.
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given: Paul
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- family: Patel
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given: Shriji
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da: '2023-09-28'
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doi: 10.1001/jamaophthalmol.2022.4566
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earlyaccessdate: NOV 2022
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eissn: 2168-6173
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files: []
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issn: 2168-6165
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journal: JAMA OPHTHALMOLOGY
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keywords-plus: 'QUALITY-OF-LIFE; UNITED-STATES; OLDER-ADULTS; VISION; GLAUCOMA; IMPACT;
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RISK; AGE; UK'
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language: English
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month: DEC
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number: '12'
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number-of-cited-references: '37'
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pages: 1219-1226
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papis_id: e60e911d19aeb8d5bcde95e3faa39bd9
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ref: Besagar2022associationsocioecon
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times-cited: '6'
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title: Association of Socioeconomic, Demographic, and Health Care Access Disparities
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With Severe Visual Impairment in the US
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000878749300002
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usage-count-last-180-days: '3'
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usage-count-since-2013: '4'
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volume: '140'
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web-of-science-categories: Ophthalmology
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year: '2022'
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