Association between geographic distribution of eyecare providers and prevalence of low vision in California

Abstract

Purpose : Low vision and vision impairment present national health concerns due to their association with increased systemic morbidity. Risk factors for low vision including age, gender, and education level have previously been explored, but the potential association between eye care provider availability and low vision has not been thoroughly studied. To address this gap in knowledge, we examined the prevalence and geographic distribution of eye care providers in relation to low vision prevalence in California.

Methods : Data regarding the number of eye care providers in California were obtained from the 2018 American Academy of Ophthalmology records and the 2020 Blue Book of Optometrists. The prevalence of low vision was determined from data reported in the 2014-2018 American Community Survey (ACS). For the purposes of this study, participants who were 18 years or older and reported blindness or difficulty seeing even when wearing glasses were considered to have low vision. The prevalence of eye care providers for each county and Medical Service Study Area (MSSA) in California was calculated as the number of eye care providers, including both ophthalmologists and optometrists, per 100,000 people. The prevalence of low vision at the same geographic areas was calculated as the number of subjects with low vision per 100,000 people. At the MSSA level, linear regression models were performed to determine the association between prevalence of eye care providers and low vision.

Results : Based on ACS data, the population of California who were 18 years and older was 29,594,578. There were 58 counties and 542 MSSAs in California. The prevalence of eye care providers was 22.18 per 100,000 California residents. The prevalence of low vision was 2,411 per 100,000 residents. For the increase of every one eye care provider per 100,000 residents, there was a decrease of 3.32±1.71 per 100,000 in the prevalence of low vision in an unadjusted model. When adjusting for ethnicity, gender, age, income, urbanity of residence location, and access to health insurance, there was a decrease of 6.39±1.35 per 100,000 in the prevalence of low vision for the increase of every one eye care provider per 100,000 residents.

Conclusions : The geographic distribution of eye care providers was widely variable in California. Higher prevalence of eye care providers is potentially associated with decreased prevalence of low vision.

This is a 2021 ARVO Annual Meeting abstract.