Abstract
Purpose :
Our objective is to determine whether a significant relationship exists between depression and social determinants of health among people with diabetic retinopathy (DR). We aim to identify factors influencing this relationship and potential tailored interventions for people from lower socioeconomic status with DR.
Methods :
We conducted a cross-sectional analysis of 18,355 respondents aged ≥40 years with and without self-reported DR using data from the pre-COVID 2019 BRFSS. Disparities in days of poor mental health and rate of depression were examined across four groups; no DR without vision impairment (VI), DR only, VI only, & DR with VI. The correlation of multiple demographic factors with mental health in the DR with VI group were then analyzed using chi-square and odds ratio. Significance tested at p-value <0.05.
Results :
The mean number of days of poor mental health per month & frequency of ever being diagnosed with a depressive disorder followed the same pattern between groups. DR with VI (9.00 days, 38.9% depression) > No DR with VI (7.83 days, 38.6%) > DR with no VI (4.75 days, 25.1%) > No DR with no VI (3.95 days, 22.4%). Significant differences exist between each group.
In the DR with VI group, among those reporting depression, difficulty concentrating or remembering (OR=5.14), difficulty doing errands alone (OR=2.03), lower income (OR=1.87), & not being able to see a doctor because of cost (OR=1.86) had increased odds of occurring compared to those who did not report depression.
Conclusions :
Of the social determinants of health tested, only an increased odds of having low income among those with depression and DR with VI was seen. Depression was significantly correlated to blindness or difficulty seeing in our population. Previous studies have found that people with depression have a 50% rate of medication non-adherence. This is a factor that is especially damaging to people with diabetes as routine blood sugar management is critical to prevent treatment needed DR. Therefore, engaging patients with DR and VI, especially those of low income, with integrated care from varying healthcare professionals to guide medication adherence, appointment attendance, and health literacy may contribute to improved outcomes. Other solutions may lie in public health policies that increase screening of low income populations to catch early signs of DR and depression.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.