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M. W. Swanson; Visual Impairment and Preventive Health Services Utilization. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4980. doi: https://doi.org/.
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Physical disability has been shown to be associated with lower utilization rates for preventive healthcare services such as mammography. Little published data exists on the utilization of preventive healthcare services by visually impaired persons. The Behavioral Risk Factor Surveillance Survey (BRFSS) is one of the major health collection tools in the United States. In 2005, a vision impairment module was added to the BRFSS and in 2006 seven states administered this module.
Public use data files were obtained from the Centers for Disease Control. The relationship of self-reported visual impairment to the utilization of eight health measures including Flu vaccination (age 65+), pneumonia vaccination (age 65+),mammogram (age 40+), PAP test (age 18+), PSA test (age 50+), blood stool test (age 50+), flexible sigmoidoscopy (age 50+), and HIV screening (age 18-64) was explored. Visual impairment was defined by the responses to the question "how much difficulty do you have in recognizing a friend across the street," with four response levels: none, mild, moderate and extreme. The extreme category included subjects who could not perform the task due to vision and were blind.
In univariate analysis on the likelihood of not having a test performed, those in the highest vision impairment category compared to those with no difficulty were more likely not to have had a mammogram (1.46 OR 1.09, 1.97 95%CI), not to have had a PSA test performed (OR 2.03 95%CI 1.22, 3.39), not to have fecal blood testing (1.55 95% CI 95% 1.15, 2.08), but were more likely to have had HIV testing (OR .62 95%CI .41, .94). Univariate associations for PAP test, sigmoidoscopy, flu and pneumonia vaccination were not significant. In multivariate analysis controlling for health status, income, race and age within group, all associations became non-significant except for HIV testing.
While subjects with higher levels of self reported vision difficulty do have lower utilization of some preventive health measures, differences can be accounted for by factors other than vision.
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