Abstract
Purpose :
Limited or unreliable transportation is an important barrier to accessing healthcare and is commonly associated with poorer health outcomes. However, little is known about the impact of transportation access on eye health outcomes. The purpose of this cross-sectional study was to examine the relationship between access to transportation and ocular diseases among participants of the National Institutes of Health All of Us Research (AoU) Program.
Methods :
Participants in AoU with electronic health record data who answered the survey question about delayed care due to lack of transportation were included in this study. The primary outcome was a diagnosis of glaucoma, cataracts, age-related macular degeneration (AMD), or diabetic retinopathy (DR) based on International Classification of Diseases, 9th and 10th Revision codes. The exposure was self-reported access to transportation for medical appointments. Study covariates included age, race and ethnicity, sex at birth, income, education level, insurance status, and access to an eye care provider in the last 12 months. Multivariable logistic regression examined associations between lack of transportation and each ocular disease, adjusting for all covariates.
Results :
The study population included 105,134 participants. Of these, 7,300 (6.9%) reported lack of access to transportation. Among the population, 6,537 (6.2%) had glaucoma, 13,457 (12.1%) had cataracts, 1,219 (1.2%) had AMD, and 1,516 (1.4%) had DR. Compared to participants who self-reported access to transportation, those who lacked transportation were more likely to have a diagnosis of glaucoma (adjusted odds ratio [aOR]: 1.17, 95% confidence interval [Cl]: 1.04-1.30, p = 0.007), cataracts (aOR: 1.20, 95% CI: 1.09-1.31, p < 0.001), or DR (aOR: 1.59, 95% CI: 1.34-1.86, p < 0.001) but not AMD (aOR: 1.14, 95% CI: 0.84-1.53, p = 0.377).
Conclusions :
This study found increased odds of ocular diseases for individuals who lacked transportation. These findings suggest that delays in accessing eye care due to inadequate transportation may contribute to a greater burden of eye disease in the population. Future studies should investigate the impact of transportation access on eye disease severity.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.