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B. L. Lam, K. L. Arheart, D. J. Lee, II, D. D. Zheng, S. L. Christ, A. J. Caban; Diaparity in Prevalence of Reported Visual Impairment Among US Race-Ethnic Subgroups Age 65 Years and Older: The 1999-2005 National Health Interview Survey. Invest. Ophthalmol. Vis. Sci. 2007;48(13):331.
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The US population is aging and becoming more diverse. Population-based prevalence estimates for visual impairment (VI) are unavailable in all but the largest race and ethnic subgroups, particularly for older adults. This study documents VI prevalence estimates in these smaller subgroups using data representative of the US population aged 65 years and older.
The National Health Interview Survey (NHIS) is a population-based annual survey of the US non-institutionalized civilian population. Nearly 42,000 adults 65 years of age and older participated in the NHIS from 1999-2005. Participants were asked, "Do you have any trouble seeing, even when wearing glasses or contact lenses?", and "Are you blind or unable to see at all? Participants were classified as "VI" if they responded yes to either question. SAS survey procedures were used to compute 1999-2005 pooled VI prevalence adjusted for survey weights and design effects.
The average annual prevalence of any VI for adults 65 years of age and older was 17.1% [95% Confidence Interval 16.6-17.6], which was similar to the rates reported by whites (16.7% [16.2, 17.3]). Asian Indians, Filipinos, and Other Asians and Pacific Islanders were the only race groups with reported VI rates below whites (12.9% [5.4-27.8], 12.4% [7.0-21.1], and, 13.0% [9.2-18.0], respectively). American Indians had the highest prevalence rate (23.4% [16.2-32.6]) followed by multiple race (23.2% [10.6-43.6]), African-Americans (20.4% [18.8-22.1]), and Chinese (19.5% [12.9-28.3]). VI prevalence in non-Hispanics (17.0% [16.5-17.5]) was almost identical to the rate for all US adults 65 years and older. Only Cuban-Americans reported rates (14.5% [9.9-20.8]) below the level for non-Hispanics. Hispanic subgroups with rates higher than non-Hispanics included: those reporting more than one Hispanic designation (40.3% [25.1-57.6]), Dominicans (23.8% [15.7-34.5]), Central/South Americans (21.7% [16.3-28.2]), Puerto Ricans (21.1% [17.5-25.3]) and Mexican-Americans (17.1% [15.1-19.4]).
There is 3-5 fold difference in reported VI rates when comparing race and ethnic differences in older Americans. American Indians and participants indicating multiple Hispanic designations report the highest rates of VI. Understudied race/ethnic groups with higher rates of VI include Dominicans, Central/South Americans, and Puerto Ricans. Ocular epidemiology studies directed at these subgroups should be considered.
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