Abstract
Purpose :
Black, Hispanic, and children from less affluent homes are less likely to access eye health services. The aim of this study was to assess vision health disparities among United States (US) adolescents.
Methods :
This cross-sectional study utilized the National Health and Nutrition Examination Survey (NHANES) from 2005-2008. Subjects included in the analysis were aged 12 to 18 years with a completed visual function questionnaire and eye examination. Outcomes included self-reported visual function and objective LogMAR visual acuity. Sociodemographic factors investigated included race, ethnicity, family income, and US citizenship status. Multivariable logistic and linear regression analyses were conducted to examine the association between the sociodemographic risk factors and each outcome, adjusting for age, sex, and all other covariates.
Results :
The 3,006 participants included represent a survey-weighted 60 million US adolescents of which 15% were Black, 17% were Hispanic, 6% were non-US citizens, and 19% had a family income below the poverty threshold. There was increased odds of self-reported poor vision in subjects who were Black (OR=2.91; 95% CI=2.08-4.08; p<0.001), Hispanic (OR=2.96; 95% CI=1.82-4.81; p<0.001), and low-income (OR=2.39; 95% CI=1.59-3.59; p<0.001). There was a trend towards worse visual acuity in the worse-seeing eye in subjects who were Black (β=0.06; 95% CI=0.03-0.09; p<0.001), Hispanic (β=0.05; 95% CI=0.01-0.09; p=0.023), and non-US citizens (β=0.10; 95% CI=0.01-0.18; p=0.034). Similar relationships were observed in the visual acuity in the better-seeing eye.
Conclusions :
Black race, Hispanic ethnicity, and low-income status increased the odds of self-reported poor vision and were associated with worse objective visual acuity in this nationally representative sample of US adolescents. Sociodemographic vision health disparities exist at an early age and interventions targeted towards younger children may be helpful to address future visual impairment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.