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Xinzhi Zhang, Mary Frances Cotch, Asel Ryskulova, Susan A. Primo, Parvathy Nair, Chiu-Fang Chou, Linda S. Geiss, Lawrence Barker, John E. Crews, Jinan Saaddine; Vision Health Disparities in the United States by Race/Ethnicity, Education, and Economic Status. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2597.
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To assess vision health disparities in the United States by race/ethnicity, education, and economic status
We used national survey data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS). Main outcome measures included age-related eye diseases (age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], glaucoma) and eye care utilization (eye doctor visits and cannot afford eyeglasses when needed) among those with self-reported visual impairment. The estimates were age and sex standardized to the 2000 census population. Linear trends in the estimates were assessed by weighted least squares regression. Findings were considered statistically significant if the p-value was <0.05.
Non-Hispanic whites had a higher prevalence of AMD and cataracts than non-Hispanic blacks, but a lower prevalence of DR and glaucoma (all p<0.001 in NHANES 2005-2008). From 1999 to 2008, individuals with less education (<high school vs >high school) and lower income (Poverty Income Ratio [PIR]<1.00 vs PIR≥4.00) had consistently less eye care visits compared to their counterparts (all p<0.05). During this period, inability to afford eyeglasses increased among non-Hispanic whites (trend p=0.004), those with high school education (trend p=0.036), and those with PIR 1.00-1.99 (trend p=0.001).
Observed vision health disparities suggest a need for educational and innovative interventions among socio-economically disadvantaged groups. Continuing efforts to raise the public awareness of eye diseases and vision loss, which are common, serious, costly, and many times preventable, should be considered.
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