Abstract
Purpose :
To examine the association of self-reported vision impairment (VI) with measures of difficulty accessing healthcare
Methods :
We used cross-sectional Behavioral Risk Factor Surveillance System (BRFSS) data, pooled across years 2019-2021. BRFSS participants included a nationally representative sample of U.S. adults ≥18 years whose responses were collected via state-based telephone interviews. Survey weighted, age-standardized, multivariable logistic regression models, adjusted for relevant sociodemographic confounders, were used to examine the association of VI (self-reported blindness/serious difficulty seeing) with four measures of healthcare access difficulty: (1) absence of healthcare insurance coverage, (2) absence of a primary care physician [PCP], (3) >1 year since last health checkup, and (4) could not afford care).
Results :
Among 1,258,919 adults, the majority were ≥45 years (54%), female (51%), and White (62%), and 5% reported VI. From 2019 to 2021, greater proportions of adults with VI had no healthcare insurance coverage and could not afford care, as compared to adults without VI (Figure 1). In multivariable logistic regression models, adults with VI had greater odds of reporting absence of healthcare coverage (OR=1.2, 95%CI=1.2-1.4]), absence of a PCP (OR=1.1, 95%CI=1.0-1.2), >1 year since last checkup (OR=1.1, 95%CI=1.0-1.2), and not affording healthcare (OR=1.9, 95%CI=1.8-2.0), than adults without VI. Also, Black race (vs. White), Hispanic ethnicity (vs. not Hispanic), and being gay/lesbian/bisexual (vs. straight) was associated with greater difficulty accessing healthcare across all four models.
Conclusions :
Adults with VI face greater challenges accessing healthcare than peers without VI. Further, racial, ethnic, and sexual minorities also experience healthcare access disparities. Identifying these barriers is crucial to ensuring equitable healthcare access to maintain health and prevent illness among all Americans.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.