Purpose:
Visual impairment (VI), especially in its severe forms, can lead to transportation challenges, social isolation and depression, which may in turn adversely impact preventive health care utilization practices. Using nationally representative data on community-residing adults, we examine the relationship between self-reported VI status and health screening activities.
Methods:
We used data from 89,785 (representing approximately 110 million) adult participants aged 40-74 years from the 2000-2007 Medical Expenditure Panel Survey (MEPS) to determine the prevalence of health screening activities among persons with no VI, some VI, and severe VI. Health screening requirements were determined using recommendations of the American Dental Association, American Cancer Society, the Centers for Disease Control and Prevention, and the U.S. Preventive Services Task Force. Logistic regression was used to estimate health screening prevalence adjusted for survey year, age, sex, race/ethnicity, marital status, education, and insurance status. SAS SURVEY procedures were used to accommodate the complex survey design of MEPS.
Results:
The prevalence of some VI and severe VI (blindness) was 7.4% and 0.4%, respectively. There were no significant differences in the prevalence of cholesterol screening, prostate screening (i.e., PSA testing), and in annual preventive physical examinations by category of VI. There were no significant differences in health screening activities of those with severe VI in comparison to those with some or no VI, except that those with severe VI were significantly more likely to have received an annual flu shot (37% vs. 30% and 28%). Those reporting some VI were significantly less likely to report dental check-ups, cervical and breast cancer screenings relative to those with no VI, although annual flu shots and colon cancer screening was significantly higher in those with some VI versus no VI.
Conclusions:
There is no evidence that persons with severe VI are underutilizing preventive services relative to those with some or no VI, after controlling for other sociodemographic factors, such as insurance status. Women with some VI are being screened for breast and cervical cancer at rates lower than women reporting no VI.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications