June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
The association of social determinants of health with cataracts in the U.S.
Author Affiliations & Notes
  • Muhammad Ali
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Abdelhalim Awidi
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Jiangxia Wang
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Varshini Varadaraj
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Cindy Cai
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Divya Srikumaran
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Pradeep Y Ramulu
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Alfred Sommer
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Fasika Woreta
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Muhammad Ali None; Abdelhalim Awidi None; Jiangxia Wang None; Varshini Varadaraj None; Cindy Cai None; Divya Srikumaran None; Pradeep Ramulu None; Alfred Sommer None; Fasika Woreta None
  • Footnotes
    Support  Pooled Professor Grant, Wilmer Eye Institute & P30EY01765 (Wilmer Biostatistics Core Grant) from the National Eye Institute, Bethesda, Maryland
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4243. doi:
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      Muhammad Ali, Abdelhalim Awidi, Jiangxia Wang, Varshini Varadaraj, Cindy Cai, Divya Srikumaran, Pradeep Y Ramulu, Alfred Sommer, Fasika Woreta; The association of social determinants of health with cataracts in the U.S.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4243.

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

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Abstract

Purpose : Social determinants of health (SDOH) are factors defining an individual's social environment that impact eye care and vision outcomes. We used nationally representative data from the National Health Interview Survey (NHIS) to investigate the association of person-level SDOH, including gender, race/ethnicity, level of education, economic stability, employment, and access to healthcare with cataracts in the U.S.

Methods : Sociodemographic and health data for adults aged ≥18 years was extracted from NHIS cycles 2008, 2016, and 2017. Participants were asked if they had ever been diagnosed with cataracts and whether they had undergone cataract surgery. Multivariable logistic regression analysis, adjusted for age, was used to assess the association between SDOH variables and self-reported cataract diagnosis and surgery.

Results : Of the total 81,551 participants, 44,950 (55.12%) were females. 13,453 (16.50%) reported a diagnosis of cataracts, of which 8,012 (59.56%) had undergone cataract surgery. Americans who were unemployed or retired were more likely to report cataracts than working individuals (OR, 1.63; 95% CI, 1.50-1.77). They were also more likely to undergo cataract surgery (OR, 1.39; 95% CI, 1.22-1.58). Individuals who delayed any type of medical care because they could not get an appointment soon enough were more likely to report cataracts than those who had no issues obtaining appointments on time (OR, 1.29; 95% CI, 1.14-1.46). They were also less likely to have undergone cataract surgery (OR, 0.81; CI, 0.68-0.98). Individuals who reported their health status as excellent, very good, or good were less likely to report cataracts than those who reported fair or poor health (OR, 0.76; 95% CI, 0.70-0.82) with no significant difference in odds of undergoing cataract surgery. Compared with Whites, Blacks (OR, 0.68; 95% CI, 0.61-0.77), and Hispanics (OR, 0.63; 95% CI, 0.54-0.72) were less likely to self-report a diagnosis of cataract. Blacks were also less likely to have undergone cataract surgery (OR, 0.76; 95% CI, 0.63-0.91).

Conclusions : Unemployed or retired status, difficulty accessing care, and fair or poor health status were significantly associated with higher odds of reporting cataracts. Future research regarding the impact of SDOH and vision loss from cataracts in terms of its severity, bilaterality, and access to surgery are warranted to address avoidable health disparities.

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

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