June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Neighborhood-Level Social Determinants of Health and Follow Up
Author Affiliations & Notes
  • Noah Heilenbach
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
    Population Health, New York University Grossman School of Medicine, New York, New York, United States
  • Titilola Ogunsola
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
    New York Medical College, Valhalla, New York, United States
  • Ceyhun Elgin
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
  • Dustin Fry
    Drexel University, Philadelphia, Pennsylvania, United States
  • Yara Abazah
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
  • Ahmed Aboseria
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
    SUNY Downstate Health Sciences University, New York City, New York, United States
  • Rahm Alshamah
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
  • Jad Alshamah
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
  • Steve Mooney
    University of Washington, Seattle, Washington, United States
  • Gladys Maestre
    The University of Texas Rio Grande Valley, Brownsville, Texas, United States
  • Gina Lovasi
    Drexel University, Philadelphia, Pennsylvania, United States
  • Vipul Patel
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
  • Mina Iskander
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
    New York Medical College, Valhalla, New York, United States
  • Lama A Al-Aswad
    Ophthalmology, New York University Grossman School of Medicine, New York, New York, United States
    Population Health, New York University Grossman School of Medicine, New York, New York, United States
  • Footnotes
    Commercial Relationships   Noah Heilenbach None; Titilola Ogunsola None; Ceyhun Elgin None; Dustin Fry None; Yara Abazah None; Ahmed Aboseria None; Rahm Alshamah None; Jad Alshamah None; Steve Mooney None; Gladys Maestre 1DP1AG069870-01, 5 R21 EY029605-02, Code F (Financial Support); Gina Lovasi None; Vipul Patel None; Mina Iskander None; Lama Al-Aswad AI Optics, Topcon Medica Systems Inc, Zeiss, Aerie Pharmaceuticals, Code C (Consultant/Contractor), New World Medical Inc, Save Vision Foundation, Code F (Financial Support), GlobeCheck, Code I (Personal Financial Interest)
  • Footnotes
    Support  Russell Berrie Foundation and Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2797 – A0127. doi:
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    • Get Citation

      Noah Heilenbach, Titilola Ogunsola, Ceyhun Elgin, Dustin Fry, Yara Abazah, Ahmed Aboseria, Rahm Alshamah, Jad Alshamah, Steve Mooney, Gladys Maestre, Gina Lovasi, Vipul Patel, Mina Iskander, Lama A Al-Aswad; Neighborhood-Level Social Determinants of Health and Follow Up. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2797 – A0127.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate whether our screening program targeted low socioeconomic neighborhoods in New York City and whether physical disorder and social vulnerability correlate with follow up after ophthalmic screening.

Methods : The TeleOphthalmology Mobile Unit screened 957 participants for cardiovascular risk factors and common causes of blindness. The participants’ demographic information and residential addresses were collected at the time of screening. Physical disorder scores were generated using the CANVAS virtual audit system. Google street view was used to evaluate building conditions, building vacancy, graffiti, and litter. Physical disorder ratings were interpolated using ordinary kriging and each participant was assigned a score based on a 500-meter radius around their address. Social vulnerability scores were generated using data from the Centers for Disease Control 2018 Social Vulnerability Index (SVI) database. Each participant was assigned the SVI score of their residential census tract. Multinomial logistic regression was performed to identify predictors of successful follow up (N=156) as compared with lack of follow up (N=160) or inability to contact (N=228).

Results : The mean summary SVI score of the study population recommended for follow up was 0.81 (SD=0.21), with 0 indicating low vulnerability and 1 indicating high vulnerability. Age of participants was inversely correlated with failing to follow up with an ophthalmologist after screening (coefficient=-0.28; p=0.008). Population density of the Census tract was inversely correlated with being unreachable by the researchers (coefficient=-4.77e-06; p=0.042). Per capita income, percentage uninsured, and physical disorder were not significantly different between those who did follow up and those who did not follow up or could not be reached.

Conclusions : Our study participants disproportionately live in Census tracts that are more socially vulnerable than the national average. Older patients were more likely to follow up and may have had more symptomatic disease or more serious diagnoses. Population density was positively associated with follow up, possibly because denser tracts in New York City have more affluent residents and greater access to medical care. Our study demonstrates that the SVI can identify populations in need of eye care and that older patients are more likely to follow up than younger patients.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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